a comparison of trans-cranial and trans-sphenoidal approaches for vision improvement due to pitutary adenomas

to improve visual disturbance, optic nerve decompression can be performed via transcranial or tran-sphenoidal approaches. although the surgical exposure in transcranial approach is favourable, yet the optic nerve's presence in the field may make it vulnerable to damage. of fighty patients with different types of pituitary adenomas, 35 cases with medium-sized (1-3 cm) tumors have been studied in a randomized clinical trial during a three year period, to compare the applicability of these approaches. while short hospital stay with better visual outcome was observed in fifteen trans-sphenoidal cases, in comparison to 20 trans-cranial cases, however the preoperative visual status and underlying disorders were similar in both groups. decompressing the optic apparatus, trans-sphenoidally, seems beneficial, where there are no contraindications for the procedure in medium-sized pituitary adenomas