Pituitary Adenomas

Abstract

Pituitary adenomas are benign lesions commonly encountered in clinical practice. Functioning adenomas often result in symptoms related to hormone excess, whereas nonfunctioning adenomas often present later with symptoms secondary to mass effect of the tumor. Diagnosis is done by way of laboratory testing and magnetic resonance imaging (MRI). Transsphenoidal pituitary resection (TPR) is the mainstay of treatment for pituitary adenomas and poses unique challenges as it involves the principles and practices of both endocrine and neurosurgical management. Airway management may be difficult in patients with acromegaly or Cushing disease. The anesthetic management for pituitary surgery requires comprehensive preoperative assessment of hormonal function and airway anatomy. Intraoperative management revolves around facilitating surgical exposure while providing hemodynamic stability and allowing for rapid emergence. Postoperative disorders of sodium balance and pituitary hormone deficiency are common after pituitary surgery.