Endoscopic Transsphenoidal Brain Surgery in Northern New Jersey
Overview of Endoscopic Transsphenoidal SurgeryPerformed by a neurosurgeon along with an ENT surgeon, endoscopic transsphenoidal surgery is an advanced minimally invasive approach used to remove tumors that have grown near the base of the skull bone called the sphenoid wing. The surgery occurs across or within the sphenoid bone hence the name “transsphenoidal”.
The major benefit of endoscopic transsphenoidal surgery in addition to its small incision is that it leaves no visible scar and minimizes the likelihood of postoperative surgical complications. Further, it reduces the patient’s time spent recovering by weeks. The CNSO neurosurgeons, a team of medical professionals have years of experience performing endoscopic brain tumor surgery.
The most common type of tumor removed using this transsphenoidal approach is a pituitary adenoma . It grows within the pituitary gland which is a pea-sized organ that sits at the base of the brain behind the nose and near the sphenoid wing. The pituitary gland’s function is to produce an appropriate amount of certain hormones. Any type of tumor that grows within the pituitary gland disrupts the level of hormone production and their release into the circulatory system. Several types of pituitary tumors include:
- Pituitary adenoma: The most common type of pituitary tumor. Pituitary adenomas are typically benign and can grow large enough to disturb vision.
- Invasive pituitary adenoma: Usually benign, this is a pituitary tumor that has metastasized to other parts of the skull, dura, or sinuses.
- Pituitary carcinoma: This is a rare cancerous pituitary tumor. It may invade certain parts of the nervous system, with the most likely being the brain.
- Hormone-secreting tumor: This is a tumor that grows on the pituitary gland and impacts natural hormone production. It can cause several symptoms, such as unusual hair growth, high blood pressure, or heart issues.
When used to remove a pituitary tumor, it is referred to as endoscopic pituitary surgery. The endoscopic transsphenoidal surgical approach can also be utilized for the removal of other types of tumors found near the pituitary gland and sphenoid bone. If the mass is reachable via an endoscopic transsphenoidal approach, this minimally invasive surgery can be used to treat brain tumors such as:
- Craniopharyngioma: A benign brain tumor which grows near the pituitary gland.
- Meningioma: A tumor which develops anywhere along the meninges which is a tissue that surrounds the brain as well as the spine.
- Chordoma: A tumor which forms in the bone and can develop in the base of the cranium.
- Rathke’s cleft cyst: This mass grows between the two lobes of the brain near the pituitary gland. It is typically filled with fluid.
For more information, contact the CNSO team of medical professionals who will ensure each patient’s individual conditions are taken into consideration.
Considerations for Endoscopic Brain Tumor Surgical Removal
Patients should consult with a CNSO neurosurgeon who will review and determine the best course of action given the individual patient’s medical condition. The surgeon will choose the treatment with the best outcome for the patient. Whether the best results would be achieved via endoscopic transsphenoidal surgery, a different type of brain surgery, or non-invasive care, the benefits as well as its risks will be explained in great detail. Any questions that arise will be answered. Once the patient is comfortable with their chosen path forward, they will be scheduled for treatment.
In the event that a surgical solution is recommended, physicians will need to ensure that the patient’s health is optimal prior to the surgery. Medical clearance testing may include:
- Blood tests
- Heart tests
- Vision tests if vision has potentially been affected by the tumor
On the day of surgery, the doctors will ask patients to avoid eating or drinking any substances.
During the Procedure
Endoscopic transsphenoidal surgery is performed under general anesthesia. During the procedure, surgeons use a thin tube-like device with a fiber optic camera called an endoscope. An endoscope allows the surgeons to easily visualize the anatomy throughout the procedure without having to make a large incision to directly visualize. Once the patient is asleep, the surgeon places the endoscope through the patient’s nasal passage. The endoscope also allows the surgeon to pass instruments through its side channels to aid in accessing the sphenoid sinus and continue along the path to the tumor in the brain. Neurosurgeons will use neuronavigation and real-time imaging techniques during the procedure to continuously appreciate where within the brain they are operating and to ensure accuracy. Using these combined advanced technologies, the CNSO neurosurgeon can remove tumors in small parts with the utmost care and precision. Typically, pituitary removal using this procedure is completed within four hours.
Post-Surgical Care for an Endoscopic Brain Surgery
Patients undergoing endoscopic brain surgery will remain under observation for 24 or 48 hours after the procedure is complete. During this time, vital signs are monitored, CT and MRI scans may be taken, and patients are encouraged to get out of bed as soon as they’re able. In addition, nurses may also check for vision problems and bowel or urinary disfunction. If the patients were to have any postoperative symptoms, the most likely would be:
- Nasal congestion
Medications may be given to help keep these and other symptoms under control. When discharged, doctors assign at-home care instructions that patients must adhere to. For example, doctors suggest that patients avoid straining physical activities for a period of time. In addition, there would be follow-up appointments after the procedure to monitor both the success of the surgery and guard against reoccurrence. After-care regimens are unique to each patient so the CNSO doctors inform their patients of any specific instructions for a healthy recovery.
Receiving Treatment at Centers for Neurosurgery, Spine & Orthopedics
At Centers for Neurosurgery, Spine & Orthopedics, patients benefit from the experienced team of medical professionals who take a collaborative, compassionate approach to patient care. With a dedication to overall health and wellness, the philosophy at CNSO is to take a conservative approach when possible, before recommending surgery. But brain tumors require decisive action. The award-winning neurosurgeons, as well as pain management, physical medicine, and rehabilitation physicians at CNSO have been trained at top-tier institutions in the country. Together they offer every available treatment to patients across Northern NJ. To schedule an in-person consultation or telemedicine appointment, contact CNSO today.