When prepped for a transsphenoidal hypophysectomy, what surgical approach is most likely to be employed if the tumor is small?

In the context of a transsphenoidal hypophysectomy, the most commonly employed approach for accessing the pituitary gland, particularly for smaller tumors, is via the sphenoid sinus. This approach involves making an incision through the nasal cavity to access the sphenoid sinus, which sits directly beneath the pituitary gland.

Utilizing the sphenoid sinus allows for a minimally invasive procedure, which is advantageous not only for tumor removal but also for reducing complications associated with larger incisions that would be required in different approaches. For smaller tumors, this method provides an effective pathway to reach the pituitary gland while preserving surrounding structures and minimizing recovery time for the patient.

Other approaches may be used for larger tumors or when greater access is required, but the sphenoid sinus approach remains the standard for smaller lesion cases due to its effectiveness and lower risk profile.