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Surgery for Pituitary Tumors

Pituitary tumor surgery involves removing all or most of the tumor that's growing on your pituitary gland.

But what type of surgery you have depends on the type of pituitary tumor you have, as well as the tumor's size and shape.

Surgery is typically needed for 2 reasons:

  • If the tumor is pressing on your optic nerves, which can potentially lead to blindness
  • If the tumor is producing too much of a certain hormone (eg, growth hormone), which can cause an endocrine disorder (eg, acromegaly)

There are 2 main types of surgery for pituitary tumors:

  • Endoscopic transnasal transsphenoidal approach: Although "endoscopic transnasal transsphenoidal" is hard to pronounce, it's easy to understand. With this surgery, your doctor uses special tools to remove your tumor through your nose (transnasal) and sinuses (transsphenoidal). One of the tools your doctor will use is called an endoscope, which is a tiny video camera that helps guide your surgeon during your surgery.

    Many patients like this option because there is no visible incision, which means no scar. Generally no other part of your brain is touched. However, extremely large pituitary tumors may be too hard to remove with this type of surgery, especially if they've spread to healthy tissue.

  • Transcranial approach: This surgery is a type of craniotomy (brain surgery). Cranium means your skull, so craniotomy is brain surgery that involves reaching your tumor through an incision on the side of your cranium or forehead.

    Your surgeon will remove your pituitary tumor through a small incision in the upper part of your skull—that's why it's called transcranial (which means through your skull). With this approach, it's much easier to reach larger tumors.

Surgery to remove a pituitary tumor typically takes about 3 hours, and most patients leave the hospital within a couple of days.

For the first few weeks after surgery, you may feel tired, have a headache, or slight nasal congestion, but these symptoms should gradually improve. And within 2 weeks, you should be back to your normal daily activities, including work.

Removing a pituitary tumor may cause abnormal hormone levels. That's because your pituitary gland may produce lower levels of some hormones (eg, thyroid-stimulating hormone) once the tumor is gone. To get your hormone levels back to normal—and to keep them there—you'll most likely need to take hormone replacement.

Pituitary tumor surgery is considered low-risk for young, healthy people. However if you're older or have other medical problems, your surgical risks increase, and these risks need to be balanced against the expected benefits of surgery. It's important to talk to your doctor about whether surgery is a good option for you.

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