From 1975 both trans-sphenoidal and transcranial operations have been utilized for visual pathway decompression or removal of small functioning adenomas. The particular surgical route is selected on the basis of the size, situation, shape and secretory capacity of the tumour, the state of vision, and the state of the patient. Radiotherapy is given to all non-secreting tumours and all invasive or surgically uncontrolled secreting tumours. All patients are managed in a combined clinic where radiotherapists, endocrinologists, ophthalmologists and neurosurgeons function together.