What are the surgeries for pituitary tumors? Does pituitary tumor surgery require opening the skull?

When it comes to pituitary tumor surgery, many patients are terrified. When hearing the name of this surgery, many people instinctively think, "It's too scary to open the brain." In fact, most pituitary adenomas now clinically do not require craniotomy and can be removed minimally invasively through the nostrils and sphenoid sinus.

The sphenoid sinus is an air cavity surrounded by bones not far from the posterior nasal opening. Its bony structure surrounds the pituitary gland, which is the pituitary fossa. The pituitary gland sits firmly on the depression on the back of the sphenoid bone, just like riding a horse, so this part of the sphenoid bone is also called the sella turcica. During the operation, the doctor passes through the nostrils and opens the sphenoid sinus to enter the pituitary fossa. With the help of a microscope or endoscope, the doctor can complete the operation in a smaller operating space to reduce the trauma caused by the operation. The pituitary gland is located in the middle of the skull and is very deep. How can we reach the sella turcica without opening the skull?

There are currently three basic pathways in clinical surgery:

1. Enter the sphenoid sinus through the posterior nasal opening to perform the pituitary tumor removal operation. This method is currently the most common method.

2. Another method is to open a "tunnel" along the nasal septum to reach the sphenoid sinus.

3. Another traditional method is the sublabial approach, which involves making an incision at the root of the upper lip, i.e., the root of the upper teeth, passing through the upper gums into the nasal cavity and then reaching the sphenoid sinus.

Of course, accidents are unavoidable. For some larger tumors, doctors may need to perform craniotomy, so please follow the doctor's advice based on the specific clinical situation.