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Treatments &

Transsphenoidal Surgery

Transsphenoidal means "through the sphenoid sinus." The sphenoid sinus is one of the air spaces behind the nose. Most pituitary tumors can be surgically removed transsphenoidally using a microscope or an endoscope. Most of these procedures are done through the nose (transnasally), although the sphenoid sinus may also be reached through an incision under the upper lip. More information about endoscopic endonasal surgery can be found in this article.

Since transsphenoidal techniques access the pituitary gland through the nose, both a pituitary neurosurgeon and an ENT surgeon may jointly perform your surgery. The pituitary neurosurgeon will perform the pituitary surgery on the gland and brain to remove the tumor.

Patient Benefits:

  • The procedure is minimally invasive, meaning less postoperative discomfort, fewer complications, and a shorter recovery period.
  • Transsphenoidal surgery alleviates the need to fully open the skull, meaning fewer risks for neurologic injury because of less exposure of the brain and less operating time.
  • Hospital stays are relatively short, and you can return to normal activities several weeks after surgery depending on the indications for surgery and your postoperative progress.
  • Patients who have pituitary tumors removed using this technique generally have excellent outcomes in experienced hands.

Patient Risks:

  • A potential risk in removing a pituitary tumor is damage to the pituitary gland, which may result in the need for hormone replacement therapy.
  • Damage to the posterior pituitary may result in a condition called diabetes insipidus, which may or may not be permanent.
  • Rarely, a cerebrospinal fluid leak may occur, which can lead to meningitis. Surgery may be required to repair the leak.
  • Even less likely, the carotid arteries, located on either side of the pituitary gland, can be damaged during surgery, leading to a stroke or blood loss.
  • Damage to the structures of the sinus can result in nasal deformity and sinus congestion.