Endoscopic Brain Surgery

Researchers estimate about 20 percent of all people develop a pituitary tumor. Most are benign and cause no symptoms. In fact, many are only found at autopsy. Malignant pituitary tumors are very rare. The American Cancer Society estimates only about 140 malignant pituitary tumors have ever been reported in medical journals.

In some cases, benign pituitary tumors can grow and press on surrounding vessels, nerves and structures in the brain. That can lead to vision problems, facial numbness or pain, headache, dizziness or loss of consciousness. Some tumors can secrete specific hormones, leading to symptoms associated with overproduction of those hormones (like excess growth, changes in sexual function, changes in appetite/weight, sleep loss, sweating, joint pain, heart disease, rapid heart rate, bone loss and mood changes).

If a pituitary tumor is causing symptoms, doctors may decide to remove it. Traditionally, pituitary tumors have been removed through an incision inside the mouth or by cutting/drilling through the skull. A newer option for some patients is endoscopic surgery.

A narrow surgical instrument, called an endoscope, is passed through one of the nasal passages to the sphenoid sinus. The pituitary gland is located on the other side of this sinus cavity. Next, tiny instruments are used to open the sinus, access the pituitary gland and remove the tumor.

Joseph Han, M.D., Otolaryngologist, Eastern Virginia Medical School says the endoscopic approach means less cutting, and a faster recovery and less scarring for the patient. Endoscopic surgery may not be possible for patients with large or oddly-shaped pituitary tumors.