Transsphenoidal Surgery

At Montefiore Einstein Otorhinolaryngology – Head and Neck Surgery, you can access exceptional care for pituitary tumors or pituitary conditions using transsphenoidal surgery. As a global leader in otorhinolaryngology and head and neck surgery, we are an academic-based, national and international referral site for the most complex and high-risk cases. For over a century, we have been at the forefront of innovation, research and clinical care for ear, nose and throat (ENT) and head and neck conditions.

Ranked in the top 1% of all hospitals in the nation for complex specialty care according to U.S. News & World Report, Montefiore Einstein continues to make advances in the diagnosis and treatment of ENT and head and neck conditions. Our multidisciplinary team of world-renowned specialists has pioneered many of the otorhinolaryngological techniques used today and is passionate about uncovering the latest diagnostic approaches and treatments that can improve outcomes.

At Montefiore Einstein Otorhinolaryngology – Head and Neck Surgery, you can expect compassionate, personalized, research-based treatment plans that meet the highest standards for quality and safety.

When you need transsphenoidal surgery, turn to our dedicated providers who will develop a highly personalized treatment plan.

Transsphenoidal surgery is a type of surgery performed through the nose and sphenoid sinus (a hollow space in the sphenoid skull bone around the nose) to remove the pituitary gland or tumors that are in or near the pituitary gland. The pituitary gland is a small organ located at the base of the brain behind the top of the nose. Commonly referred to as the “master gland” of the endocrine system, the pituitary gland secretes hormones that control and regulate many other organs and essential body functions.

Transsphenoidal surgery may be needed to treat a variety of tumors or lesions of the pituitary gland. One of the most common reasons for transsphenoidal surgery is to remove pituitary adenomas (both micro- and macroadenomas) which can cause vision disorders, hypopituitarism (a condition where the pituitary doesn’t produce enough of one or more hormones) or pituitary apoplexy (rapid enlargement of a tumor caused by bleeding or loss of blood supply). Pituitary apoplexy may demonstrate progression or enlargement on serial imaging studies or does not respond to medical management. It can be used to treat other lesions, including Rathke’s cleft cysts, craniopharyngiomas, meningiomas, chordomas or metastatic lesions.

There are several different transsphenoidal surgery approaches which include the following.

• Endoscopic endonasal transsphenoidal approach is a minimally invasive surgical technique performed through the nose and sphenoid sinus using an endoscope (a thin tubular device with a light and camera attached) to facilitate illumination and improved magnification and visualization.
• Microscopic transnasal transsphenoidal approach is performed through a single nostril of the nose to reach the sphenoid sinuses.

Transsphenoidal surgery is an effective, minimally invasive surgical technique for removing pituitary tumors or lesions, as well as other intrasellar tumors at the base of the skull where the pituitary gland is located. It may be associated with minimal morbidity and reduced length of hospital stay compared to craniotomy. The surgery may improve or restore endocrine function or hormone balance. It may remove or reverse pressure effects on the pituitary gland or surrounding structures such as the optic nerve. Transsphenoidal surgery may also improve or restore vision in individuals who had preoperative compression of the optic chiasm (the part of the brain where the optic nerves cross) and associated visual impairments, such as visual loss or field defects.