Transsphenoidal surgery: What patients need to know
Transsphenoidal surgery is a specialised procedure used to remove pituitary and skull base tumours through the nose. This article explains how it works, which conditions it treats and what patients can expect.
Transsphenoidal surgery is a minimally invasive procedure that enables surgeons to remove certain tumours located at the base of the brain. The term 'transsphenoidal' means "through the sphenoid sinus," which is the air-filled space behind the nose that provides access to the pituitary gland and nearby structures.
Specialists most frequently utilise transsphenoidal surgery to treat pituitary tumours. Because the surgical team accesses the tumour via the nasal passages rather than through the skull, this method often shortens recovery time and prevents visible scarring.
Why is transsphenoidal surgery performed?
Consultants recommend transsphenoidal surgery when a tumour affects hormone levels, vision, or surrounding structures. The pituitary gland produces many vital hormones. When a tumour develops, it may cause the gland to produce either too many or too few hormones.
Patients may experience symptoms such as headaches, visual disturbances, fatigue, or changes in weight and mood. In these cases, transsphenoidal surgery can remove the tumour and help restore balance.
Conditions treated with transsphenoidal surgery
Specialists use transsphenoidal surgery to treat several conditions affecting the pituitary gland and skull base. These include:
- Pituitary adenoma – a tumour that grows from the pituitary gland and may disrupt hormone production
- Craniopharyngioma – a benign tumour that develops near the pituitary stalk
- Rathke's cleft cyst – a fluid-filled cyst between the anterior and posterior lobes of the pituitary gland
- Meningioma – a tumour that grows from the membranes surrounding the brain
- Chordoma – a rare malignant tumour that develops in the bones of the skull base
Your consultant will assess your imaging, hormone levels and overall health before recommending transsphenoidal surgery.
Experiencing symptoms?
If you are experiencing symptoms related to nerve compression, the London Neurosurgery Partnership can guide you on the next steps.
How transsphenoidal surgery works
Transsphenoidal surgery involves a collaborative approach between a neurosurgeon and an ear, nose and throat specialist. The ENT surgeon prepares the nasal passage to enable safe access to the sphenoid sinus. Using an endoscope or microscope, the team carefully guides their instruments to the tumour.
The surgeon removes the tumour via the nasal cavity without opening the skull. This method minimises trauma to the surrounding tissue and offers a more direct route to the affected area.
Because transsphenoidal surgery is highly specialised, surgeons rely on detailed imaging guidance to ensure accuracy and safety throughout the procedure.
Recovery after transsphenoidal surgery
After transsphenoidal surgery, patients typically stay in the hospital for monitoring. The medical team carefully observes hormone levels and neurological function. Most patients experience nasal congestion or mild discomfort during the early recovery phase.
Consultants provide clear advice on activity levels and wound care. Patients should avoid heavy lifting and strenuous activities during the first few weeks. Follow-up appointments enable the team to track hormone levels and confirm successful tumour removal.
In many cases, patients notice improvement in symptoms once hormone levels stabilise. However, recovery times vary depending on tumour type and individual health.
Frequently asked questions
Is transsphenoidal surgery safe?
Specialist teams perform this procedure regularly. As with all surgery, there are risks, but consultants will discuss them in detail before treatment.
Will I still need pain medication?
Some patients may require hormone replacement after transsphenoidal surgery, depending on how the pituitary gland functions following tumour removal.