If your doctor has recommended you undergo pituitary gland tumor surgery, learning more about the procedure itself can be a useful tool to help you understand what to expect. There are two types of pituitary gland tumor surgery: a transnasal, transsphenoidal approach and craniotomy. The following information will review the details of both and give you a general idea of what each surgery involves and how the two differ. By educating yourself about your treatment options, you will be able to play a more active role in your healthcare.
About the Pituitary Gland
To better understand pituitary gland tumor surgery, it can be helpful to know a little about the anatomy and function of the gland itself. The pituitary gland is about the size of a pea and sits just behind and above the back of your nose in an area of the skull called the sella turcica. It is made up of a variety of cell types, each of which secretes a different hormone into your bloodstream and regulates a number of important physiological processes.
Sometimes a pituitary tumor is problematic because it grows and impinges on surrounding tissues, producing symptoms and affecting your body’s ability to function. Other pituitary tumors may be made up of cells that release extra, unwanted hormones into the body, resulting in abnormal physiological effects. Some people have tumors that need to be removed due to both an impingement and excretion of hormones, while others only show symptoms of a single cause.
Pituitary Gland Tumor Surgery Option #1 – Transnasal, transsphenoidal approach
For most patients with pituitary gland tumors, a transnasal, transsphenoidal approach will be the recommended treatment. This is a minimally invasive approach that uses a small incision and specialized equipment to access the tumor transnasally, or through the back of your nose. Recall that the pituitary gland sits just behind and above the nose, so a transnasal, transsphenoidal approach is often adequate to access the site.
If you are scheduled for pituitary gland tumor surgery, you will be scheduled for a few consultations prior to your procedure. The first will be with an endocrinologist, to check your hormone levels. The second will be with an ophthalmologist, who will screen you for any visual abnormalities.
The surgery itself takes place in a hospital and you will be under general anesthesia. This means you will not be awake during the procedure. The surgeon creates a small incision at the back of the nasal cavity and uses an endoscope or operative microscope to visualize the area. He or she then uses special instruments to remove the tumor, disturbing as little of the surrounding tissue as possible in a minimally invasive approach.
The length of the procedure will depend on the complexity of the tumor. A non-complex tumor removal will take approximately two hours, while more complex cases tend to take upwards of four hours. Your overall hospital stay will be two to three days, with four to six weeks of recovery at home.
Pituitary Gland Tumor Surgery Option #2 – Craniotomy
Though a transnasal, transsphenoidal approach is used most often, some patients will need to undergo a craniotomy instead. This may be the case if your tumor is large or difficult to access. You will still need to consult with an endocrinologist to check your hormone levels and a visual screening with an ophthalmologist prior to your procedure, as described above.
A craniotomy is also performed in a hospital setting while you are under general anesthesia. During this procedure, the neurosurgeon will remove a small section of your skull, generally just large enough to access your tumor. He or she will then remove as much of the tumor as possible. Sometimes, if a tumor is difficult to access, part of it will be left behind, requiring follow-up radiation therapy or a second surgery. The surgeon will replace the piece of bone, which is typically held in place using small screws or a plate and close the incision with sutures or staples.
The recovery time for a craniotomy is similar to that of an endoscopy. You can expect to spend two to three days recovering in the hospital and four to six weeks recovering at home before returning to your previous activities. However, every patient is different and your recovery timeline may vary depending on your individual case.
The Right Treatment for You
At this point, you should have a more thorough understanding of pituitary gland tumor surgery treatment options and what each procedure involves. Because pituitary gland tumors are variable, it is important to work with a doctor who has experience and knowledge when it comes to their treatment. You are an individual with a unique health history and wishes and your doctor will develop a treatment plan that is appropriate for you.
If you find you still have any questions or concerns about your upcoming pituitary gland treatment surgery, be sure to bring them up with your doctor at your next appointment. He or she will be glad to review the procedure with you and address any concerns you may have before your treatment date, ensuring you are comfortable before, during and after your surgery.
