The pituitary gland is located in a hollow area of the skull, behind the nasal passages and below the brain. It can be accessed by surgeons in 1 of 2 ways: through the nasal passages and through the sphenoid sinus (transsphenoidal surgery) or through an opening in the front and side of the skull (craniotomy).
Cancerous cells (tumors) may occur in your pituitary gland. They may require pituitary surgery they are causing symptoms that are not controlled by medications, if they create pressure on nearby structures, such as nerves and blood vessels, or if they are cancerous.
Our experienced team of surgeons will access the type, size, and location of your pituitary tumor to determine which type of surgery is right for you.
Transsphenoidal surgery is the most common and least invasive type of pituitary surgery. The Aurora neurosurgical team uses the Expanded Endoscopic Endonasal Approach (EEEA). This allows doctors to:
- Examine the pituitary gland without making incisions
- Decompress the area and remove the tumor through the nose and nasal cavities
During the procedure, your surgeon passes a tiny microscope through the normal nasal passage, and makes a small hole in the back of the passage to reach the pituitary gland. The microscope projects an image of the pituitary gland and the tumor on a television screen, allowing the surgeon to use instruments through the same passageway to remove the tumor.
No part of the brain is touched in this type of surgery, decreasing the chance for any type of brain damage to occur. Also, there is no visible scar. Our experienced neurosurgeons have a high success rate of removing small pituitary tumors with this method.
The benefits of EEEA, a minimally invasive procedure, include:
- Faster recovery time
- No risk of disfigurement
- Shorter hospital stay
Craniotomy surgery is necessary for larger or more complicated pituitary tumors. The surgeon will access the pituitary gland through openings in the skull. The risk for brain damage is higher with this type of surgery, because the surgeon must work beneath and between the lobes of the brain to access the pituitary gland. However, if the tumor is large, this type of surgery is actually safer than transspenoidal, because it allows the surgeon to see all aspects of the tumor as he works around the surrounding tissue.
Pituitary Surgery Success Factors and Risk
The success of surgery to remove pituitary tumors depends on the size of the tumor, and how much it is affecting the tissues surrounding it.
Reactions to anesthesia, bleeding, or infection are extremely rare, but they are possible. Most people who have transspenoidal surgery will experience a sinus headache and congestion for up to 2 weeks after surgery. There is a small risk of damage to the surrounding tissues, nerves, and arteries around the pituitary gland.
Some patients may experience diabetes insipidus (a hormonal imbalance that results in excessive thirst) right after surgery, but it usually resolves in 1 or 2 weeks.
Pituitary Surgery Recovery
Most of our patients will spend 2 nights in the hospital after surgery. We fully expect you to be up, eating, and walking around the next day. All of your vital signs will be monitored, as well as your hormone levels. Most likely, you will go home with a prescription for antibiotics to avoid the risk of a sinus infection.
The Aurora Neuroscience Innovation Institute (ANII) brings together world-class physicians and cutting-edge technology. Learn more about ANII.