ABSTRACT
Recurrence of pituitary adenomas after traditional microsurgical removal is not uncommon. In the relevant literature, recurrence rates for pituitary adenomas vary between 7% and 21%. Surgery for recurrent tumours is indicated in presence of mass effect or systemic effects of persistent hormonal hypersecretion, as observed in Cushing's disease and acromegaly/gigantism. The computed tomography (CT) can provide additional surface points during surgery and thus increase navigation accuracy. Recurrent tumours must first be distinguished between secreting or non-secreting; this classification carries implications during the procedure itself regarding goals of surgery. A rescue flap is elevated in most patients undergoing an endoscopic endonasal resection of a pituitary adenoma. In this setting, the rescue flap allows the mobilization of the pedicle from the face of sphenoid, therefore allowing for a wide sphenoid opening without compromising the blood supply to the nasoseptal flap. Free tissue grafts are commonly used to reconstruct skull base defects after an endoscopic endonasal approach (EEA) for a recurrent pituitary adenoma.
