title: Principles of Pituitary Surgery.
abstract: Since the description of a transnasal approach for treatment of pituitary tumors, transsphenoidal surgery has undergone continuous development. Hirsch developed a lateral endonasal approach before simplifying it to a transseptal approach. Cushing approached pituitary tumors using a transsphenoidal approach but transitioned to the transcranial route. Transsphenoidal surgery was not "rediscovered" until Hardy introduced the surgical microscope. An endoscopic transsphenoidal approach for pituitary tumors has been reported and further advanced. We describe the principles of pituitary surgery including the key elements of surgical decision making and discuss the technical nuances distinguishing the endoscopic from the microscopic approach.
authors.affiliation: Department of Neurological Surgery, Thomas Jefferson University, 909 Walnut Street, 2nd Floor, Philadelphia, PA 19107, USA. Electronic address: christopher.farrell@jefferson.edu.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Farrell
authors.affiliation: Department of Otolaryngology, Thomas Jefferson University, Philadelphia, PA, USA.
authors.forename: Gurston G
authors.initials: GG
authors.lastname: Nyquist
authors.affiliation: Department of Otolaryngology, Thomas Jefferson University, Philadelphia, PA, USA.
authors.forename: Alexander A
authors.initials: AA
authors.lastname: Farag
authors.affiliation: Department of Otolaryngology, Thomas Jefferson University, Philadelphia, PA, USA.
authors.forename: Marc R
authors.initials: MR
authors.lastname: Rosen
authors.affiliation: Department of Neurological Surgery, Thomas Jefferson University, 909 Walnut Street, 2nd Floor, Philadelphia, PA 19107, USA.
authors.forename: James J
authors.initials: JJ
authors.lastname: Evans
mesh_terms: D004724:Endoscopy / Q000379:methods*; D006801:Humans; D008279:Magnetic Resonance Imaging; D009666:Nose / Q000601:surgery*; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D010902:Pituitary Gland / Q000601:surgery*; D010911:Pituitary Neoplasms / Q000601:surgery*; D014057:Tomography, X-Ray Computed
keywords: Endoscopy versus microscopy; Pituitary surgery; Pituitary tumors; Transnasal; Transsphenoidal