Transsphenoidal pituitary tumor surgery procedure
Mar 13, 2023
Source: Cainiu Health
Dr. Li Feng
Introduction
The surgeon inserted the endoscope and operating instruments through the nostril. Upon reaching the anterior sphenoid sinus, the nasal mucosa was dissected. Part of the anterior and posterior walls of the sphenoid sinus were removed to expose the dura mater. An opening was made in the dura mater, and a curette was used to scrape out the pituitary tumor, while residual tumor tissue on the dura was excised. The sphenoid sinus cavity was then packed with a dural patch and gelatin sponge. All instruments were withdrawn, and the procedure was completed.
Transnasal transsphenoidal pituitary tumor resection refers to a microscopic surgical procedure for removing pituitary tumors via the nasal transsphenoidal approach, which is a minimally invasive surgery. The operation must be performed at a qualified hospital, and the specific steps are as follows:
1. The patient lies in a supine position with the head slightly elevated by 15 degrees and the face turned approximately 30 degrees toward the surgeon. The anesthesiologist administers general anesthesia, while the surgeon routinely disinfects the nasal cavity and drapes the surgical field.
2. After anesthesia takes effect, the surgeon inserts the endoscope and operating instruments into the two nostrils separately.
3. The endoscope and instruments pass through the nasal passages to the anterior region of the sphenoid sinus. Here, the nasal mucosa is separated, and then bone rongeurs are used to open the anterior bony wall of the sphenoid sinus.
4. Once inside the sphenoid sinus cavity, a high-speed drill is first used to abrade the posterior wall of the sphenoid sinus, followed by removal of part of this posterior wall using bone rongeurs.
5. After opening the posterior wall of the sphenoid sinus, the dura mater is exposed, and a small incision is made in it using microscissors.
6. A curette is used to scrape out the pituitary tumor, and any residual tumor tissue on the dura mater is also removed. All excised tissues are then extracted together.
7. The sphenoid sinus cavity is packed with dural graft material and gelatin sponge. All instruments are withdrawn, and the procedure is completed.
After surgery, patients should rest adequately, maintain a light diet rich in high-protein foods, and keep a positive mindset without excessive psychological stress. If any abnormalities occur, medical attention should be sought promptly.
