The transsphenoidal microsurgery for huge pituitary adenomas

objective:To evalute the availability and indications of transsphenoidal microsurgery for huge pituitary adenoma（mor than 60 mm in diameter）. Methods:All the tumors were removed by transsphenoidal approach firstly,and were classified into three types on the basis of the position of the tumor, namely, extracranial type,the major part of the tumor in infrasellar,in 4 cases; in-sellar type : the major part of the tumor roughly the same in sellar and suprasellar,in 14 cases; and suprasellar type : the major part of the tumor in suprasellar,in 6 cases. Results:Nine tumors（37.5%）were totally removed, seven（29.2%） were subtotally, Five （20.8%）were most partially and three（12.5%）were partially removed. There was no mortality nor severe complications.Conclusion:Transsphenoidal surgery for most of the patients with the huge pituitary adenoma is more safe, more effective and more simple as compared with the trancranial operation . But the operation requires a high level of technicals and rich clinical experience. Although the tumor in a part of cases can not be removed by radical at the first stage operation,the volume of the tumor is reduced, the two stage reoperation via transsphenoidal or transcranial approach was performed according to the position and size of the residual tumor safely.