{"id":"db0a1840-e8ca-4fd3-8dff-5c7bce8eafc2","slug":"endoscopic-endonasal-transcavernous-approach-for-removal-of-pituitary-macroadenoma-with-apoplexy-technical-nuances-2","title":"Endoscopic endonasal transcavernous approach for removal of pituitary macroadenoma with apoplexy: Technical nuances","authors":["Izabella Jadwiga Brykczyńska","Francesco Carbone"],"abstract":"Background: The article by Shahid et al. discusses the surgical management of a giant pituitary macroadenoma presenting with apoplexy, emphasizing the endoscopic endonasal transsphenoidal approach. The authors highlight the technical requirements necessary for approaching hemorrhagic pituitary adenomas, particularly the use of micro-Doppler ultrasonography. Summary: The letter commends the educational value of the article, particularly its insights into the surgical challenges posed by the tumor's extension into the cavernous sinus and the associated cranial nerve palsies. It also discusses the potential benefits of advanced visualization techniques, such as indocyanine green (ICG), for intraoperative guidance in complex cases. Conclusion: The authors believe that while the article provides a comprehensive overview of current surgical strategies, further studies are needed to evaluate the role of ICG in improving intraoperative visualization and surgical outcomes in pituitary apoplexy cases. Keywords: pituitary macroadenoma, apoplexy, endoscopic surgery, micro-Doppler, indocyanine green, cavernous sinus, surgical techniques","thumbnailUrl":"https://sni-digital-videos.s3.amazonaws.com/placeholders/specialty/neuroendoscopy.png","publishDate":"2025-11-14T00:00:00.000Z","doi":"10.25259/SNI_750_2025","categories":["Neuroendoscopy","Letter to the Editor"],"fullTextUrl":"https://surgicalneurologyint.com/api/articles/db0a1840-e8ca-4fd3-8dff-5c7bce8eafc2/pdf"}