Pituitary is the central of human endocrine system. The pituitary operation
has a high danger because of many factors, including its deep location in the
middle of skull base, surrounded by lots of important nerves and vessels, etc.
Pituitary adenoma is one of the most common intracranial tumors, counts 10%
of all, and this number tends to aggravate year and year. As the growing of
the tumor, it not only can break the balance of endocrine system, but also can
invasive its surrounding structures causing some significant neurological impairment.
As the development of microneurosurgery, navigation and neuroendoscopic techniques,
pituitary surgery has a deep improvement in the choice of approaches and usage
of new techniques during the operation. Microinvasive techniques such as transnasal
sphenoidal approach and neuroendoscopic techniques are more and more used in
pituitary adenomas operations. As one kind of the most common tumors, pituitary
adenoma removal can be carried out in all suitable hospital. But there still
are some gaps with the international level in the aspects of our operation conceptions
and techniques. Peking union medical college hospital neurosurgery pituitary
adenomas management center has carried out many studies in the management of
pituitary adenomas which cost several generations’ efforts. Our operations
on pituitary adenomas are more than 4,000 cases. Before the last century 70th,
we began to choose the transnasal sphenoidal approach to do the pituitary adenomas
operation. Besides, our studies have won the first grade prizes of national
technology advancement. In this atlas, we not only summarize our many years’
experiences in pituitary operation, but also list out relating skull base anatomy
and endoscopic anatomy studies materials.
This atlas consists of two parts. The first part is the different approaches and related neurological anatomy for pituitary surgery. We wrote this part by a process of different approaches. The related microanatomy and live operation pictures are listed out, from the body position and skin incision to the neurological structures and vessels during the operation. The second part is the typical pituitary adenomas cases in Peking union medical college hospital, including the image materials before and after the operation, some pictures during the operation and some block diagrams.
Our aim to publish this atlas is to assist the operation. The readers can be high year residents and attending physicians of the neurosurgery, ENT department and head cervical surgery department. I hope every readers can gain some improvements in operation skills and can do every pituitary adenomas operations.