Some pituitary tumors, although small, can actively secrete various hormones such as growth hormone, prolactin, and adrenocorticotropic hormone. Excessive secretion of adrenocorticotropic hormone can lead to Cushing’s disease.
Clinically, when patients are diagnosed with pituitary tumors, they are often faced with the difficult choice of whether surgery is needed and what kind of surgery to choose. Generally speaking, endocrinologically active pituitary tumors generally require surgery (some lactogenic pituitary tumors can also be considered for treatment with the drug bromocriptine, but require lifelong medication), while some small non-functioning pituitary tumors can be considered for observation. There are two main considerations regarding the choice of surgery, one is the extent of surgical resection and the other is the degree of surgical trauma. In terms of the extent of surgical resection, the vast majority of current studies have concluded that there is no major significant difference between microscopic and neuroendoscopic transsphenoidal surgery. On the other hand, neuroendoscopic surgery has a significant advantage in terms of the degree of trauma. We have started to develop a new technique of neuroendoscopic surgery for pituitary tumors since 2009, and have performed more than 400 cases of related surgery. For the vast majority of pituitary tumors, a minimally invasive single nostril neuroendoscopic surgery will achieve good results, rather than blindly using a bilateral nostril surgery, which may cause unnecessary damage to the nasal structures.