What to expect with endoscopic, transphenoidal surgery.

Frequently Asked Questions

After endoscopic surgery, your nose may feel stuffed for a few days but there will be no packing. You should not blow your nose for two weeks so that the reconstruction of the skull base is not dislodged. Most people go home between 2-4 days after surgery depending on the size of the tumor, the risk of leakage of cerebrospinal fluid and the function of the pituitary gland. You may feel tired and not have your full energy for a few weeks after surgery but this should shortly return to normal.
The risk of damaging the normal pituitary is always present during pituitary and parasellar tumor surgery. This risk increases with the size of the tumor. It is important during surgery for pituitary tumors and craniopharyngiomas that the entire tumor be removed to try and cure the disease. If this results in the loss of pituitary function, then hormone replacement therapy can be instituted. Nevertheless, the risk of permanent damage to the normal pituitary is usually quite low.
Most benign tumors in the brain are slow growing and can invade adjacent structures. If the tumor has invaded the cavernous sinus, which is an adjacent vein that contains the carotid artery and the nerves that control eye movements, then the tumor cannot be completely removed with surgery. In this case, the risk of recurrence is high and radiation therapy is usually recommended. If the tumor has been completely removed, the risk of recurrence is lower and may be less than 10%. In spite of aggressive surgical therapy, the surgeon may leave microscopic cells behind that cannot be seen and may grow into larger tumors over time. Using the endoscopic technique, with its improved visualization over traditional microscope-based surgery, the risk of recurrence should be lower.
A spinal drain is a very thin catheter that is sometimes placed in the lower spine to drain cerebrospinal fluid. Most patients do not require a lumbar drain after surgery. However, if there is a leakage of cerebrospinal fluid that occurs during your surgery, occasionally your surgeon will elect to place a lumbar drain to assist in the healing process. If this occurs, your hospitalization may last 3-5 days.