Most of the pituitary non-functional microadenomas are not treated, even if there is a tumor, but surgery is the first choice for non-functional macroadenomas, and there are also some medications.
Patients with acromegaly may also have diabetes mellitus, and pituitary ACTH adenomas may be associated with hypertension, cerebral hemorrhage, or even osteoporosis. Most of the prolactin adenomas can be treated with medication, but only when large adenomas cause significant visual and visual field disorders, and when medication is not effective, surgery is the treatment of choice, so this means that different patients have different treatment options.
According to incomplete statistics, there are more than 2000 pituitary tumor surgeries a year in our country, that is, more than 2000 patients receive surgical treatment, and the overall mortality rate is less than 0.5%. The overall mortality rate is less than 0.5%. The endocrine cure rate is about 60-70%, that is, the incidence of macroadenoma and microadenoma together, and the incidence of disease is very low.
There are two main types of surgery for pituitary adenomas: one is what we used to call craniotomy, which is to open the head and then do the surgery.
Of course, there is another way called transsphenoidal sinus access surgery.
These two surgical methods are different, craniotomy is a wound on the head, such surgery is very damaging, and will affect the patient’s appearance, if the transsphenoidal sinus access surgery, now we most often use the nostril access surgery, the patient’s appearance is not changed at all, so the patient damage is small, recovery is fast, and the effect is good.
In the past, it was not possible to do it through the pterygoid sinus, but only craniotomy, and craniotomy cannot do microadenoma. Now you can do it from the transsphenoidal sinus, and you can do it as small as you want. Why can it be done? One is the surgical microscope method, without the surgical microscope we would not be able to go through the nostrils and do this surgery through the pterygoid sinus. There is also an endoscope, and these two devices help us to do this surgery through the nostrils, which we also call microsurgery for pituitary adenomas.
In this way, the pituitary gland and the tumor can be clearly distinguished during the surgery, and the tumor can be removed while preserving the normal pituitary gland.