Which is better: transsphenoidal surgery or craniotomy for pituitary macroadenoma?

Depends. Transsphenoidal approach has been standard for years as it avoids brain retraction and optic nerve manipulation. In larger tumors with more of a suprasellar location (think in the brain), a craniotomy is occasionally required to reach the whole tumor.

Related Questions

Which is better for pituitary macroadenoma: transsphenoidal surgery or craniotomy?

Depends. Assuming it is an operative mass: this really depends on what the tumor looks like on imaging. Most of these masses can be done via transphenoidal approach with microscope or endoscope. Rarely it gets so large and if the patients medical condition is ok can be done via combined transphenoidal and craniotomy. Patients recover from transphenoidal surgery more quickly than craniotomy. Read more...

Transsphenoidal surgery or craniotomy for pituitary adenoma?

Either may be right. Transphenoidal surgery is the preferred procedure. However, sometimes it cannot be done--the tumor cannot be adequately reached --and a craniotomy is then required. Read more...
First Option. Transsphenoidal approach has become the surgery of choice for pituitary adenomas. Read more...