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Endoscopic Pituitary and Skull Base Surgery

Minimal access, ENT-neurosurgery teamwork, and structured recovery pathways

Book Pituitary Consultation
1-2 days
Typical Hospital Stay
Uncomplicated pituitary cases discharged early
70-90%
Vision Improvement
For patients with visual field compression
24/7
Neuro ICU Support
Critical care and endocrine monitoring

When to Consult

  • Persistent headaches with visual blurring or tunnel vision
  • Hormonal symptoms such as irregular periods, galactorrhea, or acromegaly features
  • Incidental pituitary lesion noted on MRI
  • Clear nasal discharge suggestive of CSF leak
  • Tumors extending to the skull base requiring minimal access approach
  • Recurrent pituitary tumor after prior surgery

Understanding Endoscopic Pituitary and Skull Base Surgery

Pituitary tumors and skull base lesions often sit near critical nerves and blood vessels. Endoscopic endonasal surgery uses the natural nasal corridor to reach these areas without external incisions. This approach reduces brain retraction, lowers pain, and speeds recovery while keeping precision high.

At Ajuda Hospitals, neurosurgeons and ENT surgeons operate together. This combined expertise improves access and safety for complex sellar and skull base lesions.

Common Reasons for Referral

  • Visual field loss or blurred vision from optic nerve compression
  • Headaches with hormonal changes
  • Incidental pituitary lesions found on MRI
  • Recurrent tumor after earlier surgery
  • CSF leak or skull base defects needing repair

How We Diagnose and Plan Surgery

We start with endocrine panels and vision testing, then obtain a dedicated pituitary MRI. ENT nasal endoscopy evaluates the corridor. A multidisciplinary team reviews imaging and symptoms to decide if endoscopic surgery, medical therapy, or observation is best.

Treatment Pathway

Most cases are treated with endoscopic endonasal resection. When tumor extends beyond the sella, an extended approach with angled scopes and neuronavigation is used. If residual tumor remains or hormones are overproduced, we coordinate medication or focused radiation.

Recovery and Follow-Up

Patients are monitored in the neuro ICU after surgery. Nasal care and hormone checks are done in the first week, with most returning to light activities within two weeks. Follow-up imaging and endocrine reviews guide long-term plans.

Take the Next Step

If you have vision changes, hormonal symptoms, or a pituitary lesion on MRI, schedule a consultation. Our team will outline the safest, most effective treatment plan for you.

Diagnosis Approach

1

Endocrine and Vision Assessment

Hormone panel, ophthalmology visual field testing, and symptom mapping for pituitary function.

2

MRI Pituitary With Contrast

High-resolution sellar MRI to define tumor size, cavernous sinus involvement, and optic chiasm compression.

3

ENT Nasal Endoscopy

Evaluate septum and sinus anatomy to plan the endonasal corridor.

4

Multidisciplinary Planning

Neurosurgery, ENT, endocrinology, and anesthesia coordinate the safest route and post-op plan.

Treatment Options

Endoscopic Endonasal Tumor Resection

Binostril endoscopic approach removes pituitary adenomas or skull base lesions without external incisions.

High tumor removal rates with faster recovery in suitable cases
2-4 hours typical; ICU observation overnight

CSF Leak Repair

Endoscopic reconstruction using vascularized flaps and grafts to seal leaks and prevent meningitis.

Durable closure with low recurrence
1-2 hours; short stay

Extended Skull Base Approach

For select lesions beyond the sella; uses angled scopes and navigation for safe access.

Improves access while reducing brain retraction
Case-dependent; 2-6 hours

Adjunct Medical or Radiation Therapy

Medication for functioning adenomas or focused radiation when residual tumor remains.

Improves long-term control and symptom resolution
Weeks to months depending on protocol

Expected Outcomes

Treatment Timeline

Day 0-1

Neuro ICU monitoring, pain control, hormone checks

Week 1-2

Nasal care, vision recheck, return to light activity

Week 4-6

Endocrine review, MRI follow-up if indicated

3-6 Months

Hormone normalization and long-term surveillance plan

Success Metrics

  • Rapid improvement in headaches and visual symptoms
  • Low CSF leak rates with modern reconstruction
  • Short hospital stay for uncomplicated cases