Transsphenoidal management of pituitary adenomas and other selected lesions of the sella turcica

A presentation is made of 38 lesions of the sella turcica and adjacent structures. All of these patients underwent surgical management by transsphenoidal biopsy and decompression, or resection. A pathological diagnosis was established in each case. The commonest lesion is the pituitary adenoma, with follow‐up presented in 27 cases. The necessity for postoperative radiation and replacement hormone therapy is emphasized. Acceptable control of disease is possible by this treatment regimen. Four cases of cystic craniopharyngioma treated by transsphenoidal fistulization are presented, with effective long term decompression in three. Other benign and malignant lesions of the sella and sphenoid bone are presented. Surgical approaches available for transsphenoidal access to the sella, clinical presentations of the patients in this series, principles of preoperative evaluation, postoperative complications, and results of management, are reviewed.