Pituitary Disorder Treatments

Some pituitary gland disorders can be managed with medical treatments. Most pituitary tumors require a surgical intervention. To determine the best treatment for a pituitary tumor, Emory's team of doctors will consider whether it is a functional or non-functional tumor, clinical symptoms and vision status, size of the tumor, location, shape and makeup of the tumor, your age, and previous surgeries you have undergone.

Treatment Options Include

Medical Treatments 

Our neuro-endocrinologist developes personalized medical tratment plans for certain types of pituitary disorders including:

  • Functional pituitary tumors including Acromegaly, Cushing's Disease and Prolactinomas 
  • Pituitary hormone deficiencies affecting the thyroid, the adrenal glands, water balance, reproductive organs, and growth hormone (GH) secretion

Surgical Treatments

Our multi-speciality surgical team will develop individualized treatment plans for pituitary tumors. Most pituitary tumors can be surgically removed transsphenoidally or through the sinus cavity. Other pituitary surgery treatment options include craniotomy and radiosurgery. In some cases, medical therapy may be needed before or after surgery.

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. Thepituitary neurosurgeon will perform the pituitary surgery on the gland and brain to remove the tumor.

3-D Endoscopy

The Emory Pituitary Center is among the first to use a 3-D endoscope to remove pituitary tumors. This new surgical tool provides 3-dimensional (stereoscopic vision) through a small fiber optic camera at the end of a narrow tube, which allows the doctor to better navigate this delicate area at the base of the brain.

Although the pituitary gland is small, just over half an inch, it is an extremely important organ and is surrounded by critical nerves and blood vessels within a very narrow confined space at the base of the brain. It controls all other endocrine organs, such as the pancreas, adrenal, thyroid, testicles, and ovaries. Thus, problems with this gland can cause system-wide effects that can be a matter of life and death.

The new 3-D endoscope is extremely helpful for a surgeon who is operating on a small organ located at the base of brain. The pituitary is surrounded by nerves that control the eye and vessels that supply blood to the brain. Three-D imaging gives the surgeon critical depth perception, which optimizes hand-eye coordination. It provides the surgeon with the critical ability to accurately visualize and appreciate differences in form, shape and size as well as the relationships and distances between critical structures such as the gland, nerves and blood vessels in the operating field.

This tool has only recently become available, and Emory is one a handful of centers worldwide using it.

Craniotomy

If a pituitary tumor has grown particularly large or cannot be removed transsphenoidally, a craniotomy may be necessary. A craniotomy is a surgical procedure in which a bone flap is removed from the skull to reach the tumor.

Radiosurgery

When a pituitary tumor cannot be removed completely by surgery or treated with medications, radiosurgery may be considered. In radiosurgery, highly focused beams of radiation are used to treat the tumor. Emory's treatment system consists of a device which rotates around the patient and can deliver radiation at any angle, along with a device that shapes the radiation beam to match the shape and dimensions of the tumor. The system is so precise that it can target an area within four tenths of a millimeter. This means the radiation will be delivered effectively to the tumor, while sparing surrounding tissues.

Radiosurgery, like all forms of radiation, is a treatment that works gradually. Your team of pituitary doctors will work with you to determine if your symptoms are severe enough to warrant another, more fast-acting, form of treatment.

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