Pituitary adenomas are common benign intracranial tumors, accounting for approximately 10-15% of intracranial tumors, and are classified as functional or non-functional adenomas depending on hormone levels. Treatment for pituitary adenomas includes surgery, medication and radiation therapy, with surgery being the primary treatment for pituitary adenomas. The aim of surgery is to achieve the elimination of the tumor, reduce the abnormal secretory endocrinological function to normal, preserve or restore the normal pituitary function, and eliminate the potential tumor recurrence as much as possible. In the last decade or so, on the basis of mature microscopic neurosurgery techniques, combined with minimally invasive techniques and means such as neuronavigation, stereotactic and neuroendoscopic techniques, the treatment of pituitary adenoma has developed rapidly and the level of pituitary adenoma surgery is improving.
Microsurgery is a new advancement of modern surgery in the 20th century. The late 1980s to the present is the stage of improvement and gradual maturity of microsurgery in China. Microsurgery technology has matured and achieved fruitful results in basic and various application areas, while gradually improving the systematic theoretical system and developing into an emerging clinical discipline.
In recent years, with the further promotion and popularization of microscopic neurosurgery techniques in neurosurgery, microscopic unilateral nasal aperture approach through the pterygoid sinus to remove pituitary tumors has been adopted by many scholars at home and abroad. Some scholars use microscopic unilateral nasal aperture approach to remove pituitary tumor through pterygoid sinus, first put dilators to reach the anterior wall of pterygoid sinus, and then push the fracture of nasal septum to the opposite side, then use microscope to find the opening of pterygoid sinus. This is likely to squeeze part of the anterior wall of the pterygoid sinus and the fracture of the pterygoid crest to the contralateral side, thus losing an important midline localization marker, the pterygoid crest.