pituitary tumor surgery

Question 1

goal of tumor surgery

Answer 1

diagnosis, tumor removal

Question 2

What is the purpose of pituitary tumor removal

Answer 2

for cure or relief of symptoms of mass effect

Question 3

Sx of mass effect

Answer 3

headache, vision loss, pituitary hormone dysfunction, cranial nerve abnormalities

Question 4

•What tumors are appropriate for surgery

Answer 4

All pituitary tumors EXCEPT prolactin secreting tumors. Tumors that secrete both prolactin and growth hormone generally are candidates for surgical intervention

Question 5

methods for removal of pituitary tumor

Answer 5

transnasal microscopic works along the axis of the tumor, under the optic nerves. Transnasal endoscopic

Question 6

transnasal microscopic

Answer 6

Don’t have a wide field of view,

Question 7

transnasal endoscopic

Answer 7

used for more skull based fractures, wider view, more destructive, can look in more directions than the microscope so you can ensure that you remove the whole tumor

Question 8

risk of pituitary surgery

Answer 8

1. post operative CSF leak. 2. Diabetes insipidus. 3. Injury to optic nerve. 4. injury to carotid artery (stroke). 5. Injury to pituitary gland. 6. infections (chronic sinusitis or meningitis)

Question 9

How is post operative CSF leakage treated

Answer 9

Requires placement of spinal drain with increased hospital stay to 4-5 days.

Question 10

Treatment of post operative diabetes insipidus

Answer 10

DDAVP- but this is usually transiet