EDITORIAL October 01, 2016 October 01, 2016

Transsphenoidal pituitary surgery by microscopic or endoscopic approach: the still unsolved question of superiority

DOI: 10.1590/2359-3997000000219

Surgery has been the main treatment of pituitary tumors since the beginning of last century. Pioneers like Cushing, Hirsch, and Schloffer were able to foresee the advantages of the transsphenoidal approaches but had to abandon them due to technical difficulties, specially those related to surgical field lighting. Even though this method was maintained by Norman Dott, in England, and Gerard Guiot, in France, it was only in the beginning of the sixties that Jules Hardy, in Canada, brought the surgical microscope to the operating room.

Since then, the microscopic transsphenoidal approach became the gold standard for the treatment of pituitary tumors. Meanwhile, in the middle of the nineties, endoscopic surgery had already proven its efficacy in the treatment of nasosinusal diseases and, thus, its use in sellar diseases became a matter of time. The wide-angle view associated with a light source near the surgical field brought about a large number of possibilities, not only for pituitary surgery but also in the whole field of skull base surgery.

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