Endoscopic Transsphenoidal Hypophysectomy

  • Abdülkadir Imre
  • Ercan Pinar
  • Jeffrey Janus


Modern pituitary surgery began with Harvey Cushing and Oskar Hirsch during the early years of the 20th century with the development of transnasal surgery traversing the sphenoid sinus to reach the sella via a sublabial approach. Subsequently, an endoscopic transnasal transsphenoidal approach was introduced in the early 1990s. Technological advances in the field of endoscopic systems, collaboration with otolaryngologists who specialise in sinus surgery, better comprehension of endoscopic skull base anatomy, and recent innovations in reconstruction techniques have resulted in obvious improvements in the management of pituitary and cranial base lesions. Currently, an endonasal endoscopic transsphenoidal approach is the preferred route for the removal of most sellar and retrosellar lesions. Despite traditional use of an operating microscope, neurosurgeons are quickly adapting the endoscope for transnasal approaches to increase visualisation, access, and resolution. With this paradigm shift, we have seen a learning curve period for the transition from microscopic to endoscopic surgery. Close partnerships between pituitary surgeons and otolaryngologists have improved the management and follow-up of these patients. At present, pituitary tumours are best managed by a multidisciplinary team including an endocrinologist, neurosurgeon, otolaryngologist, and radiation oncologist. Thus, the treatment of pituitary tumours should be performed in specialist centres where a multidisciplinary team and all of the treatment options are available.


Endoscopic transsphenoidal hypophysectomy Pituitary surgery Transnasal approaches Multidisciplinary Treatment 


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Abdülkadir Imre
    • 1
  • Ercan Pinar
    • 1
  • Jeffrey Janus
    • 2
  1. 1.Department of OtorhinolaryngologyIzmir Katip Celebi University, Ataturk Training and Research HospitalİzmirTurkey
  2. 2.Department of OtolaryngologyMayo ClinicRochesterUSA

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