During the office visit, the surgeon will explain the procedure, its risks and benefits, and answer any questions. Next, you will sign consent forms and complete paperwork to inform the surgeon about your medical history i. Discuss all medications prescription, over-the-counter, and herbal supplements you are taking with your health care provider. Some medications need to be continued or stopped the day of surgery. Presurgical tests e.
Consult your primary care physician about stopping certain medications and ensure you are cleared for surgery. Stop taking all non-steroidal anti-inflammatory medicines ibuprofen, naproxen, etc. Stop using nicotine and drinking alcohol 1 week before and 2 weeks after surgery to avoid bleeding and healing problems. It kills bacteria and reduces surgical site infections. Avoid getting CHG in eyes, ears, nose or genital areas. Patients are admitted to the hospital the morning of surgery.
The nurse will explain the preoperative process and discuss any questions you may have. An anesthesiologist will talk with you to explain the effects of anesthesia and its risks.
Step 1: prepare the patient You will lie on the operating table and be given general anesthesia. Once you are asleep, your nose is prepped with antibiotic and antiseptic solution. An image-guidance system may be placed on your head Fig. Step 2: make an incision The ENT surgeon inserts the endoscope in one nostril and advances it to the back of the nasal cavity.
An endoscope is a thin, tube-like instrument with a light and a camera. Video from the camera is viewed on a monitor. The surgeon passes long instruments through the nostril while watching the monitor. A small portion of the nasal septum dividing the left and right nostril is removed. Using bone-biting instruments, the front wall of the sphenoid sinus is opened Fig. Step 3: open the sella At the back wall of the sphenoid sinus is the bone overlying the pituitary gland, called the sella.
The thin bone of the sella is removed to expose the tough lining of the skull called the dura. The dura is opened to expose the tumor and pituitary gland. Step 4: remove the tumor Through a small hole in the sella, the tumor is removed by the neurosurgeon in pieces with long grasping instruments Fig.
The center of the tumor is cored out, allowing the tumor margins to fall inward so the surgeon can reach it. After all visible tumor is removed, the surgeon advances the endoscope into the sella to look and inspect for hidden tumor.
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Keep reading to learn more about this rare condition. But deep brain stimulation surgery could offer relief when medications fail. Read on to learn more. However, having a family history or certain genetic conditions can significantly increase your chances of having this dangerous problem. Recovering From Pituitary Surgery. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.
Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. It looks like your browser does not have JavaScript enabled. Please turn on JavaScript and try again. Main Content. Important Phone Numbers. Topic Contents Your Recovery How can you care for yourself at home? When should you call for help? Top of the page. Your Recovery Pituitary surgery removes an abnormal growth on your pituitary gland. How can you care for yourself at home?
Ask your doctor when you can drive again. Rest when you feel tired. It is normal to want to sleep during the day. It is a good idea to plan to take a nap every day. Getting enough sleep will help you recover. Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
For 1 to 2 weeks, avoid lifting anything that would make you strain. This may include a child, heavy grocery bags and milk containers, a heavy briefcase or backpack, cat litter or dog food bags, or a vacuum cleaner.
Avoid strenuous activities, such as bicycle riding, jogging, weightlifting, and aerobic exercise, for 1 to 2 weeks. If you had surgery through your skull: Try not to lie flat when you rest or sleep for the first 1 to 2 weeks after surgery. You can use a wedge pillow, or you can put a rolled towel or foam padding under your pillow. You can also raise the head of your bed by putting bricks or wooden blocks under the bed legs.
After lying down, bring your head up slowly. This can prevent headaches or dizziness. You can wash your hair 2 to 3 days after your surgery. But do not soak your head or swim for 2 to 3 weeks. Do not dye or colour your hair for 4 weeks after your surgery. In rare cases, both types of surgery are used at the same time to try to completely remove large tumors that have spread into nearby tissues.
As a general rule, smaller pituitary tumors are easier to treat with surgery. The larger and more invasive the tumor, the less likely the tumor can be cured by surgery. Side effects also tend to be more likely after surgery to remove large, invasive tumors. Surgery on the pituitary gland is a serious operation, and surgeons are very careful to try to limit any problems either during or after surgery. Complications during or after surgery such as bleeding, infections, or reactions to anesthesia the drugs used to make you sleep during surgery are rare, but they can happen.
Most people who have transsphenoidal surgery will have a sinus headache and congestion for up to a week or 2 after surgery. If surgery causes damage to large arteries, to nearby brain tissue, or to nerves near the pituitary, it can lead to brain damage, a stroke, or blindness, but this is quite rare.
When doctors use the transsphenoidal approach to operate on the pituitary gland, they create a temporary pathway between the nasal sinuses and airways and the brain.
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