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Brain Surgery

Pituitary Tumor Excision

Most pituitary tumors could be removed by trans-sphenoidal tumor surgery. This simply means that the primary care physician goes through the nose to get to the tumor. By making a small hole in the bone here, the primary care physician could see the base of the pituitary gland and the tumor. The objective of the surgery is to remove as much of the tumor as is safe, and for most tumors, the entire tumor, could be removed safely.

How is it done?

After the patient falls asleep, the primary care physician or surgeon will use fluoroscopy a type of x-ray guidance to insert a tube up one of the nostrils. With the help of this tube, the primary care physician could use a powerful operating microscope to see to the back of the nose, and then the primary care physician creates a hole in the bone at the back of the nose to see to the base of the pituitary gland. Using the operating microscope, the primary care physician could see the difference between the normal pituitary gland and the tumor, and once the tumor is seen it could be removed.

Most pituitary tumors particularly the large ones are very soft and could either be removed in many small pieces or could be sucked out. Very small tumors might be hard to see, and this is where the experience of the primary care physician could be critical in knowing how to look around in the normal pituitary gland for a small tumor without causing any permanent damage to the normal gland.

What is the success rate?

The success rate for getting a complete tumor resection process depends upon the kind of tumor being treated and its location. Complete tumor removal is often desirable, if the tumor is too extensive or is too close to crucial nerves or blood vessels, it is more crucial not to injure normal brain tissue than it is to excise the tumor from an excessively risky area.


What are the risks?

In the vast majority of the cases, trans-sphenoidal tumor surgery is safe and useful. The most common risk is damage or injury to the normal pituitary gland. For larger tumors greater than 1 centimeter in size this occurs between 5-10% of the time once the operation is done by an expert pituitary surgeon. As a result, the patient might need to take new hormone replacement pills after the surgery, possibly involving thyroid hormone, cortisol, growth hormone, estrogen, or testosterone. Damage to the posterior, or back portion, of the pituitary gland, might produce a condition called as diabetes insipidus, which will lead to frequent urination and excessive thirst because the kidneys will no longer adequately retain water from the urine. This could be controlled with a nasal spray or pill form of a medication known as DDAVP. Permanent diabetes insipidus happens 1-2% of the time after pituitary surgery.

Dr. David Masel is well versed in minimally invasive surgery techniques to treat neurological disorders affecting the brain. If you or anyone you know is suffering from brain injuries or brain disorders like :-

  • Brain Malformations
  • Brain Tumors
  • Encephalopathy
  • Degenerative Nerve Diseases

Please book an appointment with Dr. Masel, call +1(469) 833-2927 to schedule a consultation.