Understanding Pituitary Tumor Surgery
Before recommending surgery, your doctor took into consideration all the risks and benefits of the procedure in your specific situation. While he or she will be the best person to explain those pituitary tumor surgery benefits and risks as they relate to your individual case, it can be helpful to have an understanding of the risks and benefits in a general manner. Whether you are still in the treatment planning process or already have your procedure scheduled, having a firm grasp of the benefits and risks can give you peace of mind as you move forward.
Overview of Pituitary Tumors
Pituitary tumors can be highly variable in presentation and treatment, which is why it is important to work with a specialist in the tri-state area. The pituitary gland may be small, but it is considered the control center of the body and plays an important role. Located in the area of the brain just behind the back of the nose, the pituitary gland is about the size of a pea. It secretes a number of hormones, which in turn affect other hormones and many processes throughout the body. These include growth and development, the adrenal gland, the thyroid and processes related to reproduction.
The pituitary gland is made up of many different types of cells, and each secretes a particular hormone. Your pituitary tumor is made of one or more of these cell types. If these cells secrete excess hormones, you may experience symptoms related to that excess. You may also have symptoms related to the size and location of your pituitary tumor if it impinges on nearby tissues, such as nerves. Many people have pituitary tumors that are small and asymptomatic, not requiring treatment. However, if your pituitary tumor is large and/or secreting, your doctor may recommend treatment.
Surgery for Pituitary Tumors
One form of pituitary tumor treatment available to NJ patients is surgery. Your doctor may recommend surgery as the only mode of treatment, or it may be combined with an advanced form of radiation therapy called Gamma Knife radiosurgery. Generally speaking, there are two surgical approaches used: minimally invasive and traditional transnasal transsphenoidal surgery.
Minimally Invasive Surgery
In contrast to traditional surgery, minimally invasive pituitary tumor surgery does not require a craniotomy. Instead, the surgeon makes a small incision at the back of the nose, then uses microscopic visualization and specialized instruments to access your tumor. The surgeon will remove as much of the tumor as possible, again requiring Gamma Knife radiosurgery if any tumor remains.
Minimally invasive pituitary tumor surgery also takes place in a hospital while you are asleep. However, the recovery period is generally shorter and milder due to the minimally invasive nature of the procedure. You can expect to spend two or three days recovering in the hospital, although this will depend on your specific situation.
Traditional surgery means the surgeon uses standard surgical instruments during open surgery to remove all or part of your pituitary tumor. Your doctor may recommend traditional surgery if your tumor is especially large or in a difficult area to reach using other methods. Traditional surgery takes place in a hospital while you are asleep and comfortable and typically requires a hospital stay of a week or so.
The first stage of traditional surgery to remove a pituitary tumor is a craniotomy. During a craniotomy, the surgeon removes a small section of the skull to gain access to your tumor. Next, the surgeon removes as much of the tumor as possible. If any tumor remains, you may require follow-up Gamma Knife radiosurgery. Finally, the surgeon will replace the small section of bone and close the incision site using sutures or staples. You will be monitored in an intensive-care unit as you recover from your anesthesia and will be moved to your recovery room once you stabilize.
Pituitary Tumor Surgery Benefits
If your doctor has recommended pituitary tumor surgery, it is because he or she feels the benefits outweigh the risks. One of the major benefits is some degree of relief from your pituitary tumor symptoms. This includes those symptoms related to excess hormones, as well as symptoms due to pressure from the tumor on adjacent structures. The amount of relief you experience will depend on your individual condition.
The second major pituitary tumor surgery benefit is preventing any further damage to adjacent structures, as well as the affected systems of the body. If your tumor secretes excess hormones, that could have downstream effects on other glands and physiologic functions. Surgical removal of your tumor will prevent it from growing larger and pressing on structures and will halt the production of excess hormones, increasing the chance for the body to return to normal physiologic levels.
Pituitary Tumor Surgery Risks
Again, if your doctor has recommended pituitary tumor surgery, it is because the benefits outweigh the risks and surgery is in your best interest. However, it is still important to understand what the risks are. There are risks both traditional surgery and minimally invasive surgery have in common, though the risks are generally lower with a minimally invasive approach. These include:
- Reactions to general anesthesia
- Bleeding within the brain
- Pain and infection at the incision site
- Damage to the healthy pituitary gland tissue
- Issues with vision due to nerve damage
Again, the level of risk is typically increased with traditional surgery because more tissues are disturbed during the more invasive procedure. This is why recovery is usually longer. However, there is one risk that is unique to a minimally invasive procedure using transnasal access. CSF rhinorrhea can occur, which is when CSF (cerebrospinal fluid) leaks from the nose. This condition presents itself as a constantly dripping or runny nose. Some patients may require another surgical procedure to repair the leak.
Speak with Your Doctor
Having an understanding of the pituitary tumor surgery benefits and risks is an excellent way to reduce the stress of your upcoming procedure. The information here is an excellent jumping-off point to discuss your individual benefits and risks with your personal doctor. He or she will be able to review why surgery is recommended, as well as what to expect during your recovery. Learning as much as you can about what to expect will help you have peace of mind during the process, allowing you to rest easy and focus on your health.