**9. Surgical approaches to pituitary adenomas**

Currently, pituitary adenomas are approached almost exclusively through transsphenoidal route because it offers a direct access to sellar and suprasellar region by removing of posterior wall of sphenoidal sinus. Also, it is associated with lower morbidity and it is considered a less invasive approach than the transcranial route. Either endoscopic and microscopic, transsphenoidal approach is adequate to remove intrasellar lesions with satisfactory outcomes. Recent advancements in surgical endoscopy have improved our ability to visualize and dissect normal anatomical structures from the adherent pathologies in a way that is nearly similar to microneurosurgery. However, in selected cases, transcranial approaches are still needed for resecting tumors extending to suprasellar or parasellar regions that could not be addressed by transsphenoidal approaches.
