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Where is it and what does it do?. Master Gland"Regulates all other hormone pathwaysThyroidIGF-1CortisolTestosterone/ EstrogenProlactinADHSits at base of brain just below optic nerves. Symptoms of Pituitary Tumors. Hormone deficitsDue to compression of glandHormone ExcessDue to hormone-secreting tumorsGH= AcromegalyACTH= Cushing's DiseasePRL= ProlactinomaTSH= TSH-oma Visual Deficits Due to compression of optic chiasm or nervesDue to compression of cranial nerves in cavernous sinus.
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1. Endoscopic Pituitary Surgery
2. Where is it and what does it do? “Master Gland”
Regulates all other hormone pathways
Thyroid
IGF-1
Cortisol
Testosterone/ Estrogen
Prolactin
ADH
Sits at base of brain just below optic nerves
3. Symptoms of Pituitary Tumors Hormone deficits
Due to compression of gland
Hormone Excess
Due to hormone-secreting tumors
GH= Acromegaly
ACTH= Cushing’s Disease
PRL= Prolactinoma
TSH= TSH-oma
Visual Deficits
Due to compression of optic chiasm or nerves
Due to compression of cranial nerves in cavernous sinus
4. Macroadenoma
5. Surgical Options Transcranial
Transsphenoidal
Combined
Extended Skull Base
6.
7. Endonasal Transsphenoidal Approach Preferred approach for most pituitary tumors
Approach pituitary through back of nose
Minimal tissue destruction
Utilize a rigid endoscope to illuminate and magnify
8. Endoscope and Camera
9. Transsphenoidal Surgery
10. Extended Endonasal Approaches Use nasal corridor as access to skull base
Useful for tumors from cribiform plate to C1
Primarily midline
Meningioma
Chordoma
Craniopharyngioma
Extensive learning curve and evolving field
Great way to protect the optic nerves !
12. Expanded Endonasal Surgery