Microsurgical removal of giant invasive pituitary adenomas via interhemispheric transsphenoidal approach

Objective To study the operative approaches of giant invasive pituitary adenomas. Methods Thirty cases of giant invasive pituitary adenoma were operated by the interhemispheric transsphenoidal approach. After cutting a medial frontal bone flap and reaching sellar area through interhemisphere, the tuberculum sellar, planum sphenoid and anterior sellar wall were removed by microdrill and then the tumor located at suprasellar, intrasellar and sphenoid sinus regions was exposed and excised. Skull base reconstruction were made in some cases.Results Total removal was got in 22 cases (73%). With a followup ranged from 2 to 3 years in 27 cases, there were no tumor recurrence. Twentythree patients had resumed their normal work. Conclusion By using this approach, the tumors could be displayed maximuly under microscope. This approach is the ideal method for surgery of giant invasive pituitary adenomas.