Endoscopic Surgery for Pituitary Tumors
It is a hormone gland located in the very center of the head and under the brain.
pituitary gland. WHAT IS IT?
It is a hormone gland located in the very center of the head and under the brain.
The hormones secreted from the pituitary gland and their functions are as follows:
- Adrenocorticotropic hormone: regulates cortisone secretion from the adrenal glands and is effective in controlling sleep-wakefulness, body metabolism, and sensations such as fear and anger.
- Growth hormone: ensures growth in various tissues of the body
- Prolactin: milk from the breast.
- Thyroid stimulating hormone: regulates the secretion of thyroid hormones from the thyroid gland. These hormones are important in maintaining the balance of body metabolism.
Approximately 15% of brain tumors are pituitary tumors. Most of these tumors are benign. 75% of tumors originating from the pituitary gland secrete more hormones than normal. As a result, the following conditions may occur:
- Cushing's syndrome
- Acromegaly
- Prolactinoma
- Hypothyroidism
As tumors grow, the hormone secretion function of the pituitary gland deteriorates and hormone deficiency (hypopituiterism) occurs. Large tumors can also cause visual disturbances due to the pressure they put on the optic nerve.
Symptoms:
- Enlargement of the face, swelling of the eyes
- Growth in hands and feet
- Changes in facial shape: growth in jaw, tongue and facial bones
- Weight changes: weight gain or loss
- Constipation
- Coarsening or thinning of hair, loss of body hair, thinning of eyebrows
- Skin changes
- Intolerance to cold or heat
- Low blood pressure
- Personality changes (restlessness or reluctance)
- Abnormal breast discharge or milk discharge in women, menstrual irregularities, body hair growth
- Breast enlargement, sexual reluctance in men
- Headache
- Tendency to sleep
- Nausea, vomiting
- Visual disorders: double vision, vision loss
- Convulsions e
Diagnosis:
When a pituitary tumor is suspected as a result of the examination, a magnetic resonance (MR) imaging examination is performed.
In addition, various hormone levels in the blood are examined to detect the hormone activity of the tumor (such as cortisol, FSH, LH, IGF-1, prolactin, testosterone, estradiol, TSH, T4) and vision-related examinations need to be made.
These evaluations should be carried out by experts from more than one medical field. Since the symptoms of pituitary tumors are mostly related to the function of hormones, the initial evaluation is usually made by internal medicine and endocrinology specialists. Vision-related evaluations are carried out by an ophthalmologist.
If it is decided that surgical treatment is required, the person who will perform this surgery is a brain and nerve surgeon (neurosurgery) specialist. The role of the Ear, Nose and Throat specialist is to assist the brain and nerve surgeon (neurosurgery) specialist in some pituitary gland surgeries performed through the nose. The cooperation between these two surgical specialties is valid in endoscopic pituitary surgeries, which are increasingly performed today.
Treatment:
Pituitary tumors are mostly benign; However, when they grow, they can cause serious problems by pressing on important nerves and vessels. Pituitary tumors that secrete prolactin or growth hormone can be reduced or their growth stopped with drug treatments. Apart from this, surgery is often required for treatment. Most pituitary tumors can be removed through the nose; However, sometimes surgeries performed through the skull are also needed.
There are several methods used in surgeries performed through the nose:
- Transseptal-transsphenoidal hypophysectomy performed through the nasal septum and sphenoid sinus
- Sublabial-transsphenoidal hypophysectomy performed through an incision under the upper lip
- Endoscopic transnasal-transsphenoidal hypophysectomy
The endoscopic method is increasingly preferred due to the superior imaging advantages it provides. is done. The benefits of this method for the patient are that it causes less damage to the normal tissues in the nose. healing and faster recovery, no need for a nasal tampon, or a smaller and shorter-term tampon, and fewer complications.
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