RT Book, Section
A1 Freeman, Brian S.
A2 Freeman, Brian S.
A2 Berger, Jeffrey S.
SR Print(0)
ID 1135739375
T1 Transsphenoidal Hypophysectomy
T2 Anesthesiology Core Review: Part Two Advanced Exam
YR 2016
FD 2016
PB McGraw-Hill Education
PP New York, NY
SN 9781259641770
LK accessanesthesiology.mhmedical.com/content.aspx?aid=1135739375
RD 2024/04/25
AB Hypophysectomy,  the  removal  of  the  pituitary  gland,  can  be  performed  through  a  number  of  surgical  approaches.  For  large  tumors  that  have  extended  beyond  the  pituitary  fossa,  a  bifrontal  craniotomy  is  often  necessary.  Most  pituitary  tumors  lie  within  the  sella  (or  immediate  suprasellar  area)  and  are  therefore  amenable  to  excision  via  the  transsphenoidal  technique.  Transsphenoidal  hypophysectomy  requires  the  use  of  a  microscope  or  endoscope  to  enter  the  sella  through  the  nose  and  sphenoid  sinus.  Advantages  include  rapid  midline  access  to  the  sella  with  minimal  risk  of  brain  injury  or  bleeding.  The  incision  may  be  made  in  the  back  wall  of  the  noise,  along  the  front  of  the  nasal  septum,  or  under  the  upper  lip.  Endoscopy  enables  excellent  tumor  visualization,  opening  of  the  diaphragmatic  sellae,  and  decompression  of  the  optic  nerve.