HOW I DO IT: Cushing's disease-selective adenomectomy via an endoscopic transsphenoidal approach.

Abstract

An ACTH-secreting pituitary adenoma is the most common cause of excessive endogenous glucocorticoid production resulting in Cushing's Syndrome. A multidisciplinary approach is paramount. Selective adenomectomy is the treatment of choice. Endoscopic transnasal transsphenoidal approach to the tumour, along with techniques for resection, are demonstrated. Endoscopic transsphenoidal approaches with its magnified view of the pituitary gland allows precise microsurgical dissection during selective adenomectomy. This technique increases the possibility of proving a gross total resection, leading to clinical and biochemical cure in these patients.