Pituitary adenomas are the most common sellar tumors and are mostly benign; skull base meningiomas are often technically demanding because of deep location and proximity to critical neurovascular structures. Advances in endoscopic endonasal techniques and intraoperative imaging now emphasize precise resection with functional preservation.
The endoscopic endonasal approach
The transsphenoidal route reaches the sellar region and parts of the anterior skull base through the natural nasal corridor, avoiding brain retraction associated with craniotomy. For large pituitary macroadenomas, selected craniopharyngiomas and selected skull base meningiomas, this approach provides a clear direct view.
Neuronavigation and intraoperative MRI (iMRI) help the surgeon confirm residual tumor and the position of critical structures in real time, improving the proportion of safe complete resections. Suitability depends on tumor size, invasion, prior surgery and nasal conditions.
Endocrine and multidisciplinary management
Pituitary tumors often involve hormonal hypersecretion or deficiency; preoperative endocrine assessment is required, and long-term hormone replacement and follow-up may be needed after surgery. For skull base meningiomas, attention focuses on vision, olfaction and cerebrospinal fluid leakage. The multidisciplinary team (MDT) includes neurosurgery, endocrinology, radiology and radiation oncology.
Hospital stay and recovery
Most patients stay about five to seven days after surgery and progressively resume daily activities; hormone levels and MRI are checked after discharge as scheduled. Seek care promptly for fever, copious nasal fluid leakage or sudden vision loss. Any treatment may involve contraindications; please consult a qualified physician first.
See services for neurosurgical programs, or submit imaging via online consultation to assess surgical feasibility.