Although most pituitary tumors are benign, pituitary tumor surgery is often necessary if the growth is putting pressure on your optic nerve or if the tumor causes the pituitary gland to produce excess hormones. Pituitary tumor surgery can either be performed through the sinuses or by opening up the skull. The surgery is generally low risk and most patients fully recover from it within a few weeks.
If you suffer from a tumor that is small, a doctor will usually perform pituitary tumor surgery using an endoscope, a thin instrument with a light attached that allows doctors to see inside narrow spaces. Sometimes, a high-powered microscope is threaded through a patient's sinus instead of the endoscope. The endoscope or microscope allows the doctor to clearly see the area around the pituitary gland. Images from the scope are typically projected onto a television monitor.
During this type of surgery, called a transsphenoidal pituitary tumor surgery, a doctor can enter the cavity at the base of the skull using one of three methods. The first method is known as the direct transnasal approach. A small cut can be made at the back wall of the nose so the surgeon can directly go into the sphenoid sinus. The doctor can also incise at the front of the septum and tunnel his way back to the sphenoid sinus. A third method is to enter the nasal cavity and then the sinus through an incision under the lip and gum.
If the tumor is too large to be reached and removed through the sinuses, a transcranial pituitary tumor surgery will need to be performed. During this type of surgery, the skull is cut open, typically at the forehead or to the side of the head so the doctor can reach and remove the tumor. Risks from transcranial pituitary tumor surgery are greater than for transsphenoidal surgery and include brain and nerve damage as well as damage to other organs in the body.
Most surgeries last a few hours. In any of the procedures, you will be anesthetized so you won't feel anything. After a transsphenoidal surgery, you may need bandaging on your nose, unless the surgeon used a direct transnasal approach. A transcranial surgery requires stitches and staples to close the incision. Depending on the size of the cut, you may need a metal plate to cover the incision. Your head will then be bandaged.
You can expect to stay in the hospital for another day or two after a transsphenoidal surgery or for up to nine days after a transcranial surgery. You will most likely have a sinus headache and some congestion for a couple of days after surgery. Typically, you'll be back to normal within two weeks.