报告５４例直径≥４ｃｍ的垂体巨腺瘤经蝶窦显微手术治疗结果。肿瘤近全切除４５例，大部切除５例，部分切除４例，无死亡。作者体会对垂体巨腺瘤而言，经蝶窦显微手术不但比经颅手术安全，而且切除范围也比经颅手术彻底，对视觉功能的改善更优于经颅手术。 Report of 54 cases of pituitary adenoma with diameter ≥ 4cm microsurgical treatment of the sphenoid sinus. Nearly 45 cases of tumor resection, most of the resection in 5 cases, partial resection in 4 cases, no death. The authors appreciate pituitary gland tumor, the transsphenoidal microsurgical surgery is not only better than the transcranial surgery, and the resection range than the complete transcranial surgery, visual function better than transcranial surgery.