title: Pituitary surgery: current status, including transsphenoidal surgery.
abstract: Advances in CT scanning and digital subtraction angiography have improved the accuracy of preoperative diagnosis of pituitary disease. Modern radioimmunoassay techniques are able to evaluate "subdivisions" and "relatives" of the classic pituitary hormones, including monomeric and oligomeric growth hormones, somatomedin C, beta-lipotropin, and beta-endorphin, as well as the alpha subunit of follicle-stimulating hormone. Pituitary pathologic states can now be identified immunologically in patients in whom results of radiologic studies are normal. Bromocriptine, a centrally active dopamine antagonist and ergot derivative, is effective in the treatment of prolactinomas, but it is not effective in the treatment of acromegaly. Transsphenoidal surgery remains the treatment of choice in adults with pituitary-dependent Cushing's disease. The surgical advantages of the sublabial, transseptal, transsphenoidal approach include wide-field pituitary accessibility via a midline exposure.
mesh_terms: D000236:Adenoma / Q000175:diagnosis / Q000378:metabolism / Q000628:therapy; D001971:Bromocriptine / Q000627:therapeutic use; D003131:Combined Modality Therapy; D003480:Cushing Syndrome / Q000601:surgery; D006801:Humans; D007016:Hypophysectomy / Q000379:methods*; D010900:Pituitary Diseases / Q000601:surgery*; D010901:Pituitary Function Tests; D010902:Pituitary Gland / Q000000981:diagnostic imaging; D010911:Pituitary Neoplasms / Q000175:diagnosis / Q000378:metabolism / Q000628:therapy; D011388:Prolactin / Q000378:metabolism; D011859:Radiography
chemical_list: D001971:Bromocriptine; D011388:Prolactin