The pituitary gland is located in the middle of the head just behind the sphenoid sinus. Newer less invasive techniques have been developed to address tumours of this gland entirely through the nose (endoscopically). This is usually done by a neurosurgeon in conjunction with an ENT/Skull base surgeon.
What to expect with the procedure
This procedure is performed under general anaesthesia in hospital.
Patients are typically admitted the night before for up to date scans and blood tests.
The surgery begins with creating access. The ENT surgeon creates a small window in the back of the nasal septum and opens the sphenoid sinus widely to enable access to the pituitary gland. Together with the neurosurgeon, they resect the abnormal pituitary tissue or tumour. After the tumour is resected the ENT surgeon reconstructs the bony defect with either local tissue from the nose or with thigh fat/muscle depending on the size of the tumour and whether there was a leakage of cerebrospinal fluid during the procedure. The entire procedure can take anywhere between 2-4 hours. Packing material may be inserted to support the repair at the conclusion of the procedure. If the skull base defect is large, a lumbar drain may be inserted and left in place for a few days.
After a short period in recovery, patients are typically transferred to the high dependency or intensive care unit for close monitoring for the first 24-48 hours. After this time they are sent to a general ward where they will slowly mobilize and recover over the next week. Most patients should be able to go home after 7 days.
As this is large surgery, most patients will take 4-6 weeks to recover. We don’t recommend driving during this time. Patients usually feel congested for 1-2 weeks after surgery but may also feel fatigued or have headaches for the first 3 months. Adequate an analgesia is provided
I will usually review you 2 weeks after the procedure and again at 6 and 12 weeks depending on the need.