As the name implies, pituitary tumors originate from the pituitary gland, which is the endocrine center of the human body. If we look at the human head as a sphere, the pituitary gland is basically located at the center of this sphere. In addition to its deep location, the site of the pituitary gland is also very important. For those who have not studied medicine, it may be difficult to understand the complex local anatomy. Although the location is deep and the structure is complex, fortunately there is a channel (nasal cavity) in the human head that allows more direct access to the pituitary localization. Another fortunate condition is that most pituitary adenomas are soft (and can be removed by suction), so even through a narrow channel total resection can often be achieved, which is the basis for the currently prevalent microscopic transsphenoidal pituitary tumor removal. However, for more rigid pituitary tumors, or pituitary tumors that grow upward or to the sides, it is often necessary to combine other surgical procedures, or to combine other treatments (e.g., radiation therapy).
However, one of the more obvious disadvantages of microscopic pituitary tumor resection is the limited visualization of local structures. With the development of technology, neuroendoscopic techniques have shown increasing superiority in the treatment of pituitary tumors. The main advantage of these techniques is that they can significantly expand the exposure of some of the subtle structures of the pituitary gland, because they can be observed close to the pituitary gland, thus allowing the extent of tumor removal and the relationship between the tumor and the surrounding structures, especially the important structures such as the internal carotid artery. Thus, the tumor can be removed to the maximum extent and damage to important structures can be minimized. Neuroendoscopy is in a sense an extension of the microscope and an extension of the surgeon’s field of vision, so it can significantly reduce the damage to the normal structures of the nasal cavity during transnasal surgery, greatly shortening the recovery time and making the surgery safer. However, neuroendoscopic surgery requires a deep understanding of the local anatomy (especially endoscopic anatomy) and systematic training in neuroendoscopy to master the skills of neuroendoscopic surgery.
It should be noted that surgery is only one tool in the treatment of pituitary tumors and that different treatment plans (observation, drugs, surgery, radiotherapy, etc.) should be designed for each patient depending on his or her condition and requirements. Improper treatment of pituitary tumors can often have catastrophic consequences with lifelong implications.