Have your headaches and double vision led to gradual vision loss, nausea, nasal leakage or disruptions in your sense of smell? At IGEA Brain, Spine & Orthopedics, we specialize in detecting and treating the source of your problem. If you experience any of these symptoms, you may have developed a pituitary tumor. Tumors of the pituitary gland can also affect how your body produces hormones, leading to several other disorders.
How Does it Affect You?
Pituitary tumors are usually non-cancerous and may sometimes never be detected throughout your lifetime, as they typically do not cause symptoms. Up to 20% of people have a pituitary tumor and may never realize it. However, if your tumor grows to considerable size, chances are it may compress adjacent structures located at your skull base. These important neurologic and vascular structures will require transcranial surgery for decompression and relief from symptoms such as double vision, gradual vision loss, headaches and cranial bleeding.
General Treatment for Your Condition
Typically, pituitary tumors can be treated with medication, transsphenoidal surgery, radiation or a combination. Instances where conventional treatments fail to produce desired results, or where the tumor size is beyond the transsphenoidal (through the sinus) approach, calls for a transcranial surgical method.
Craniotomy and other skull-based operations for pituitary tumor resection (removal) are rare. Tumors are often handled through the transsphenoidal procedure. Transsphenoidal surgery allows surgeons to reach the pituitary gland via the nasal passage to avoid other brain structures. Unfortunately, when a tumor has enlarged or spread to the areas above, below or adjacent to your sella (where the pituitary gland is located), surgeons must resort to the more extensive transcranial approach for removal.
Methods of Removal
The transcranial approach depends on your pituitary tumor’s size and location. The subfrontal approach allows surgeons improved visualization for removing your tumor. This technique is associated with tumor growth far above your sella. A growth in this area is usually indicated by progressive vision loss due to the tumor’s compression of your optic nerves.
The procedure requires the removal of bone from above your forehead to your eyebrow lining. Both of your brain’s frontal lobes are left exposed to be gently elevated. This allows a corridor to your pituitary gland for surgeons to access the tumor. The optic nerves in your brain are then decompressed by the removal of the tumor.
A transcavernous approach is performed in instances where a tumor reaches sideways into one or more of the adjacent cavernous sinuses on either side of your pituitary gland. Cavernous sinus surgery has been considered risky due in large part to the delicate neurostructures located within your cavernous sinus and the associated bleeding from the structure’s veins.
Advancements and studies on cavernous sinuses have led to a more knowledgeable understanding of the sinuses and the eventual removal of tumors from the area. It is noteworthy that this procedure allows for exceptional access to the cavernous sinus through your skull’s temporal side. It also increases visualization for your surgeon above the sella. It is, however, only available on one side of your head and does not allow access to areas below your pituitary gland.
Le Fort maxillotomy is used when your tumor grows through the sphenoid sinus. Although rare, surgeons approach the tumor through the front and from below your sphenoid bone when it does occur. The procedure is similar to transsphenoidal surgery, only with a greater exposure of your skull base. The exposure stems from surgeons separating your maxilla (bone holding the upper teeth) from your cheek, bone and nose. Surgeons then remove the tumor through the rear of your mouth and nasal cavity. Your maxilla is then reattached with the use of small titanium plates and screws.
How Can IGEA Brain, Spine & Orthopedics Help You?
At IGEA Brain, Spine & Orthopedics, we aim to guide you on the right path for rapid relief from your condition. If conventional methods have failed, or if your tumor extends beyond minimally invasive capabilities, extensive actions such as transcranial surgery can be performed. Our surgeons are board certified specialists who pioneer the latest technological advancements in their respective fields. Request an appointment with one of our surgeons in New Jersey and New York City or call 908-219-9673 for a specialized opinion on management and treatment for your disorder.