Hypophysectomy Transsphenoidal

The pituitary gland is a part of the brain located at the bony base of the skull. Transsphenoidal approach to the pituitary gland (transsphenoidal hypophysectomy) involves removing a tumor or cystic formation through a formation in the sphenoid sinus. This technique was developed in the mid-20th century to treat various tumors and cysts in the pituitary gland or sphenoid sinus. It is known as a "transsphenoidal transsectal excision" or simply "hypophytectomy". This method includes three stages:

1. Preparatory stage. Aspiration of fluid that is located in the hypothalamus or sphenoid cavity. The patient is seated with his head tilted forward and an IV in his nostril. The doctor sucks out the liquid from the wedge-shaped cavity to avoid its possible leakage during opening.

2. Vascular access. Before surgery, the patient is given an epidural catheter, through which the surgeon gains access to the blood vessels of the brain. This allows the surgeon to monitor the patient's blood pressure and supply.

3. Trepanation. The doctor trephines the patient's skull and attaches dilators to widen the openings in the skull and provide access to the wedge-shaped area. After widening the holes, the doctor punctures the maxillary sinus and begins the transplantation. During this process, a tumor, cyst or other abnormal formation is removed using microsurgery and microinstruments.

After the operation is completed, the doctor returns the dilators back and covers the hole with an antiseptic. The doctor also applies generous stitches to prevent bleeding and infection. This surgery can be very risky and difficult. However, when performed correctly, it is effective and can give the patient a good quality of life.

The pituitary gland is a small endocrine organ located in the skull near the sella turcica. Its main function is to regulate the activity of other endocrine glands, such as the adrenal glands, the thyroid and parathyroid glands, and the gonads (ovaries or testes). In addition, the production of pituitary hormones can affect human growth, metabolism, the functioning of other organs, and the development and functioning of the immune system.

Hypophysectomy is the procedure for removing this organ by partial excision, performed for certain indications. This type of intervention can be performed transaminally, that is, through a small incision under the nose, through the sphenoid sinus (transsphenoidal), or from a transcranial approach (from behind, through an opening in the skull).

Today, transsphenoidal hypophysectomy is the most common type of surgery. Most often it is performed to treat diseases such as acromegaly, tumor-based gigantism (gigantism), prolactinoma and a number of other pathologies.

It is performed using instruments - a knife for resection of the pituitary gland, forceps, a retractor. Using transsphenoidal insertion of instruments, the neurosurgeon “opens” the sphenoid bone and reaches the pituitary gland. The gradual removal of an organ occurs by cutting its “capsule” and pressing on it to soften it.

The duration of transsphenoid hypophysectomy is about 3 hours and is performed under general anesthesia. The only disadvantage of this procedure is the high risk of nosebleeds. Complications such as hematoma formation, concussion, or hematoma around the eyes are also possible after surgery.