“Choose Your Own Adventure!”: Endoscopic Trans-Cavernous and Trans-Pterygoid Approach for Recurrent GH-Secreting Pituitary Adenoma with Skull Base Reconstruction
Abstract
This video demonstrates a unique case of an invasive, growth-hormone secreting pituitary adenoma that was managed primarily via a trans-cavernous and trans-pterygoid expanded endoscopic approach with nasoseptal flap reconstruction. The tumor demonstrated unique features of extra-sellar extension, bony invasion, and para-sellar involvement, requiring a combined, expanded endoscopic approach. Secondary surgery, required due to sustained acromegaly, posed a unique surgical challenge involving re-use of a prior nasoseptal flap reconstruction and focused resection of para-sellar residual disease. Publication History Article published online: 27 February 2026 © 2026. Thieme. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany
Fields of Study & Subjects
Pituitary Gland Disorders and Treatments
Head and Neck Surgical Oncology
Meningioma and schwannoma management
Publication details
- Journal / source
- Journal of Neurological Surgery Part B Skull Base
- Volume
- 87
- Issue
- S 01
- Pages
- S1–S548
- Publication date
- 27 February 2026
- Language
- EN