Resection of Pituitary Macroadenoma with Bilateral Cavernous Sinus Extension and Snowman Sign
Abstract
This video demonstrates endoscopic endonasal resection of a giant pituitary macroadenoma with bilateral cavernous sinus extension. Following debulking of the sellar component, angled endoscopes facilitated dissection around carotids and suprasellar extension, enabling optic chiasm decompression. A low-flow CSF leak was repaired with synthetic dural graft and nasoseptal flap. Anatomy of the cavernous sinus and abducens nerve is reviewed through cadaveric dissection. The case emphasizes technical strategies for safe tumor removal in Knosp grade 4 lesions. 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