What is Endonasal Transsphenoidal surgery?
An endonasal transsphenoidal surgery is a form of minimally invasive surgical technique that is mostly used to remove the damaged/diseased pituitary glands, sellar region and the sphenoid sinus of the skull. This approach requires the surgeon to access the organs through the nasal cavity (nose).
This surgery may be performed using a microscope or an endoscope. Removal of tumors from the pituitary gland helps to relieve numerous discomforting symptoms that arise due to these.
The microscopic procedure involves making a small incision under the lip and removing a large part of the nasal septum so the surgeon can access the area more easily. The endoscopic procedure requires a small incision at the back of the nasal cavity that causes little disruption in the nasal tissues. The surgeon will work through the nasal cavity (nostril) by inserting a tiny high-definition video camera attached to the endoscope to view the surgical site clearly using a video monitor connected to this camera.
Both the minimally invasive procedures require making openings in the bone of the nasal septum, sphenoid sinus, and the seller to reach the pituitary gland.
Who is a candidate for an Endonasal Transsphenoidal surgery?
A patient is considered to be an ideal endonasal transsphenoidal surgery candidate when:
- Pituitary adenoma is seen growing in the pituitary gland (hormone/non-hormone secreting)
- Craniopharyngioma, a benign tumor, grows from cells surrounding the pituitary stalk (might invade 3rd ventricle)
- Rathke’s cleft cyst tumor grows in the meninges (dura) which surround the spinal cord and the brain
- Chordoma, a bone tumor of the malignant form grows from the embryonic notochord at the base of the skull
How is an Endonasal Transsphenoidal surgery performed?
An endonasal transsphenoidal surgery is performed as follows:
The first step requires the patient to be positioned on their back on the operating table. The patient will be administered general anesthesia in order to avoid discomfort or pain during the surgical procedure. A specialized image-guidance system is fixed to the patient’s head for the surgeon to perform the surgery with added accuracy.
The endoscopic procedure requires inserting the endoscope through one nostril till it reaches the end of the cavity at the back. The endoscope is a thin and flexible surgical tube which is initially fitted with a high-definition video camera and a cold light source. This endoscope gives a detailed and magnified view of the nasal structure. The surgeon will then remove the small cartilage barrier that divides the nasal septum into left and right. Bone-cutting instruments are then used to make an opening in the front wall of the sphenoid sinus.
The seller, a bone at the back of the sphenoid sinus overlying the pituitary gland, is removed to expose the tough inner lining of the skull (dura). The surgeon will next open the dura to access the tumor in the pituitary gland.
Through the small hole created in the seller, the surgeon will remove the tumor with a specialized instrument, called a curette.
The tumor is removed by first removing its core so that the outer shell of the tumor falls inward and can be removed easier. After all the visible parts of the tumor are removed, the surgeon will then insert the endoscope further inside the nasal cavity and into the sellar to look for and inspect it for any hidden tumors (cancerous activity).
Any tumor that has remained and cannot be removed safely using surgical methods is treated after the surgery with radiotherapy (radiation therapy).
The space remaining due to the removed tumor in the seller is usually filled up by using small graft portions sourced from the patient. The hole in the floor of the sellar is closed using a bone graft in the sphenoid sinus.
What are the risks associated with Endonasal Transsphenoidal surgery?
These are the risks associated with an endonasal transsphenoidal surgery:
- Blood clots
- Anesthetic allergy
- Vision loss
- Pituitary gland damage
- Diabetes insipidus (DI)
- Cerebrospinal fluid (CSF) leakage
- Sinus congestion
- Nasal deformity
- Nasal bleeding
Why choose Travcure for Endonasal Transsphenoidal surgery in India?
India is renowned for the largest network of global-class hospitals and clinics in the world. This network consists of the best and most comprehensive healthcare facilities that are equipped with ultra-modern medical technology and instruments. Travcure offers every patient treatment at one of these specialized hospitals that ensure the best and most effective treatment for the patient. Travcure provided each patient with a bespoke treatment package that allows for the best and most advanced endonasal transsphenoidal surgery at the most affordable price to the patient.