Clinical anatomy

Surgical approach

  • Sub frontal
  • Through anterior cranial fossa by elevating the frontal lobe of the brain
  • Trans sphenoidal
  • Through sphenoidal air sinus.
  • This is entered either via the ethmodial air cells after raising the periosteum from the medial wall of orbit or by elevating nasal mucosa from nasal septum

Pitituary enlargement

  • Presents with features of raised intra cranial presseure
  • Widens the pitituary fossa and erodes clinoid process and petrous crest.
  • Compresses the optic chiasma causing bitemporal hemianopia

Pitituary tumors

  • If they involve chromophils, can cause endocrine dysfunction together with compression effects
  • Chromophobe adenomas only cause pressure effects and intracranial pressure.