Transsphenoidal Hypophysectomy Overview: Procedure and Complications

Transsphenoidal Hypophysectomy is a surgical process that cures severe complications. Read on to know all about this surgical procedure.

Transsphenoidal Hypophysectomy Definition

It is a surgical method that is recommended for removal of pituitary tumors that arise from conditions like Hyperadrenocorticism (Cushing’s Syndrome) and Acromegaly.

Procedure

In case of Pituitary Adenoma, this surgery involves making an incision inside one of the noses. The tumor is removed through one of the nasal sinuses. A successful surgery quickly improves symptoms resulting from the tumor that presses on surrounding tissues. Operation also makes IGF-I and hormone growth levels normal.

During Transsphenoidal Hypophysectomy Adenoma surgery, the nose of the patient is jammed with sponge packing to soak in the drainage from the operative site. Small plastic materials known as stents are sewed to the septum of the nose. The stents and packing are taken away before sufferers leave hospital. The stitches in the lining of the gum dissolve on their own.

The surgery requires a lot of care as even a minor error can damage delicate tissues adjacent to the pituitary gland. The success of this operation depends on the experience and skill of the surgeon. Small adenomas recur in 80-85% cases and large adenomas may come back in 50-65% cases after surgery.

Some people need lifelong hormone replacement following surgical operation.

Endoscopic Transnasal Transsphenoidal Hypophysectomy

This surgical method leads to greater exposure of the vital structures that are located inside and outside the Stella. Greater exposure ensures a more accurate surgery that can keep these structures safe from any damage. It can avoid irreversible complications that may arise on account of damage to the structures during other surgical operations.

Complications

Usually, this surgery has an excellent prognosis. Little risk is involved with the process. However, the operation can lead to Postoperative Hypoadrenalism if carried out improperly. Careful monitoring is required to avoid complications from Hypoadrenalism.

In some cases, transient cases of antagonistic Antidiuretic Hormone Secretion (SIADH) may arise. This may be followed by a case of Diabetes Insipidus.

There is also a sensation of numbness in the teeth, upper lip or the gums. This usually goes away or disappears with time.

In severe cases, there may also be complications like

  • High fever
  • Stiff Neck
  • Stomach upset
  • Body rashes
  • Pain, redness or inflammation in the foot or leg which is an indication of blood clots
  • Acute chest pain
  • Shortness of breath
  • Excessive thirst and severe urination which is a sign of post-operative hormone problems

In acute cases, patients may cough up blood. This may be a sign of movement of blood clot into the lungs or some other acute health condition. During Intracranial Subfrontal Transsphenoidal Hypophysectomy anesthesia use can give rise to some severe problems. But in case of Tumoural Transsphenoidal Hypophysectomy anaesthesia use does not cause any problem.

Post Operative Care

Most patients take several weeks to recover completely after surgical operation. Patients easily get tired after Transsphenoidal Hypophysectomy surgery. Post-operative care involves taking as much rest as possible and avoiding strenuous activity. You should discuss with your doctor during follow-up appointment about how much you should increase your activity level.

However, prolonged bed rest is also bad for health. It can give rise to blood clots in the legs and lung problems. It is necessary that you go for short walks and take rest when you get tired. This will provide your body with some much needed exercise after surgical treatment.

Transsphenoidal Hypophysectomy approach is safe and gives rise to no complications if carried out properly. If you require this surgery, make sure that you get it done by an expert surgeon. This will ensure complete recovery without any harmful post-operative problems for you.

References:

http://www.rhodeislandhospital.org/rih/services/neuro/surgery/discharge/trans_hypo.htm

http://www.skullbaseinstitute.com/papers/transnasal-transsphenoidal-hypophysectomy.htm

http://www.felipedia.org/~felipedi/wiki/index.php/Transsphenoidal_hypophysectomy

http://www.wisegeek.com/what-is-a-hypophysectomy.htm

Published on July 5th 2011 by  under Surgical Procedures.
Article was last reviewed on 5th July 2011.

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