The transsphenoidal operation was first performed in the early 1900s by Schloffer, an Austrian physician, and later modified by Harvey Cushing, often called the father of modern neurosurgery. Since that time, the procedure has become an efficient and safe method to treat pituitary adenomas and related tumors.
Your endocrinologist and neurosurgeon will discuss the benefits and risks of undergoing such a procedure after your diagnosis. The risk of a serious complication is exceedingly low with today's medical technology and well-trained surgeons.
Depending on the location and size of the tumor and the surgeon's experience, varying approaches can be taken. At DHMC, we generally perform a direct approach (without an incision) through the nostrils that enter into the sphenoid sinus behind the nose. Once in the sphenoid sinus, the sella (the bony surrounding to the pituitary gland) is easily visualized. Because this approach goes through the sphenoid sinus, the term transsphenoidal has been coined.
Using a microscope, a surgeon can then remove the front bony wall of the sella, revealing the dura (membranous tissue surrounding the central nervous system). The dura is then carefully incised to reveal the pituitary gland and tumor. The tumor can then be removed while the normal pituitary gland is protected.
This operation usually only requires one to three hours to complete. Patients typically remain in the hospital for approximately two to three days following the surgery.