What is Transsphenoidal Surgery?

It is the standard surgery for removing pituitary tumors. The surgeon goes through the nose and sinuses (sphenoid sinus) to reach the pituitary at the base of the brain. There is no incision on the face or head.

When is it needed?

• Functional Tumors (except prolactinomas, which respond to meds).
• Large Tumors pressing on the optic nerves (causing vision loss).
• Tumors not responding to medication.

How is it done?

• Endoscopic Approach: A tiny camera and instruments are inserted through the nostril.
• Microscopic Approach: Using a surgical microscope.

What to Expect:

• Hospital Stay: Usually 2-3 days.
• Nasal Packing: You'll have packing in your nose temporarily. Breathing through the mouth.
• No Nose Blowing: For at least 2 weeks (to avoid CSF leak).

Risks:

• CSF Leak: Spinal fluid leaking from the nose (2-5% risk). Requires repair.
• Diabetes Insipidus (DI): Temporary or permanent (5-30%).
• Hormone Deficiencies: May need replacement therapy.
• Vision Loss (rare).

Success Rates:

• Cure Rates: 70-90% for microadenomas, lower for macroadenomas.
• Recurrence: 10-20% over 10 years.

Recovery:

• Most people return to normal activities within 4-6 weeks.
• Hormone Monitoring: You'll need frequent blood tests to check for deficiencies or tumor recurrence.