Transnasal Transphenoidal Surgery for Pituitary Tumors

In transnasal transsphenoidal endoscopic surgery, a surgical instrument is placed through the nostril and alongside the nasal septum to access a pituitary tumor. This surgery is performed with an endoscope using a small incision at the back of the nasal cavity to remove tumors from the pituitary gland. Once the pituitary is exposed, the neurosurgeon removes the tumor using an endoscope causes minimal disruption of the nasal tissues which speeds up recovery time and is less damaging on the patient.

Pituitary tumors can become large which compresses nerves and arteries at the base of the brain and can lead to vision problems. Surgical removal of the tumor can often reverses endocrine problems and restores normal hormone balance.

The surgery usually takes 2 to 3 hours and starts with the neurosurgeon placing an image-guidance system on your head used to navigate through the nose using a 3D map created from real-time scans showing exactly what is happening in real time within the patients body. The endoscope is inserted into a nostril and pushed to the back of the nasal cavity. Using specific instruments, the front wall of the sphenoid sinus is opened. The back wall of the sphenoid sinus is the sella, which is the bone overlying the pituitary gland. The sella is removed to expose the dura, which is the tough lining of the skull.

Once the dura is opened the surgeon can see the pituitary gland and tumor. The tumor is removed in pieces with special instruments through the small hole in the sella.

The endoscope is then used to inspect the surrounding area of any other abnormalities and make sure all tumor sections have been removed. The removed area in the sella is replaced with a bone graft from the septum and then biologically glued which aids healing within the nasal cavity.

Soft splints are inserted into the nose after the surgery to further help with recovery and prevent problems like adhesions from forming.

You will be transferred to the recovery room immediately after surgery, which will monitor you closely, particularly in relation to your level of consciousness and important vital signs. You should expect to spend anywhere from 1-2 days at the hospital following this procedure.

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