The transsphenoidal route remains the dominant surgical approach to the management of pituitary adenomas. These tumors may present clinically with signs or symptoms related to hypersecretion, hypopituitarism, or mass effect; or they may be identified incidentally during neuroimaging for management of other disorders. Diagnostic and treatment strategies for pituitary adenomas are reviewed. In addition, we present outcomes data from a large number of patients treated over a 30-year period by a single neurosurgeon. In our experience, transsphenoidal surgery for pituitary adenomas is associated with low rates of morbidity, mortality, and disease recurrence.
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