Transsphenoidal surgery
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Transsphenoidal surgery is a type of
surgery Surgery ''cheirourgikē'' (composed of χείρ, "hand", and ἔργον, "work"), via la, chirurgiae, meaning "hand work". is a medical specialty that uses operative manual and instrumental techniques on a person to investigate or treat a pat ...
in which an
endoscope An endoscope is an inspection instrument composed of image sensor, optical lens, light source and mechanical device, which is used to look deep into the body by way of openings such as the mouth or anus. A typical endoscope applies several modern t ...
or
surgical instrument A surgical instrument is a tool or device for performing specific actions or carrying out desired effects during a surgery or operation, such as modifying biological tissue, or to provide access for viewing it. Over time, many different kinds of ...
s are inserted into part of the brain by going through the nose and the
sphenoid bone The sphenoid bone is an unpaired bone of the neurocranium. It is situated in the middle of the skull towards the front, in front of the basilar part of occipital bone, basilar part of the occipital bone. The sphenoid bone is one of the seven bones ...
(a butterfly-shaped bone forming the anterior inferior portion of the
brain case In human anatomy, the neurocranium, also known as the braincase, brainpan, or brain-pan is the upper and back part of the skull, which forms a protective case around the brain. In the human skull, the neurocranium includes the calvaria or skul ...
) into the
sphenoidal sinus The sphenoid sinus is a paired paranasal sinus occurring within the within the body of the sphenoid bone. It represents one pair of the four paired paranasal sinuses.Illustrated Anatomy of the Head and Neck, Fehrenbach and Herring, Elsevier, 2012, ...
cavity. Transsphenoidal surgery is used to remove
tumor A neoplasm () is a type of abnormal and excessive growth of tissue. The process that occurs to form or produce a neoplasm is called neoplasia. The growth of a neoplasm is uncoordinated with that of the normal surrounding tissue, and persists ...
s of the
pituitary gland In vertebrate anatomy, the pituitary gland, or hypophysis, is an endocrine gland, about the size of a chickpea and weighing, on average, in humans. It is a protrusion off the bottom of the hypothalamus at the base of the brain. The ...
. (Such tumours, although within the skull, are outside the brain itself).


History

The transsphenoidal approach was first attempted by Hermann Schloffer in 1907. Use of the procedure grew in the 1950s and 60s with the introduction of intraoperative
fluoroscopy Fluoroscopy () is an imaging technique that uses X-rays to obtain real-time moving images of the interior of an object. In its primary application of medical imaging, a fluoroscope () allows a physician to see the internal structure and functio ...
and
operating microscope An operating microscope or surgical microscope is an optical microscope specifically designed to be used in a surgical setting, typically to perform microsurgery. Design features of an operating microscope are: magnification typically in the ran ...
.


See also

*
Pituitary adenoma Pituitary adenomas are tumors that occur in the pituitary gland. Most pituitary tumors are benign, approximately 35% are invasive and just 0.1% to 0.2% are carcinomas.Endoscopic endonasal surgery Endoscopic endonasal surgery is a minimally invasive technique used mainly in neurosurgery and otolaryngology. A neurosurgeon or an otolaryngologist, using an endoscope that is entered through the nose, fixes or removes brain defects or tumors in ...
, particularly Surgical approaches to the anterior skull base


References


External links


Transsphenoidal surgery
entry in the public domain NCI Dictionary of Cancer Terms.
Endoscopic transsphenoidal pituitary adenoma resection (IPG32)
National Institute for Clinical Excellence The National Institute for Health and Care Excellence (NICE) is an executive non-departmental public body of the Department of Health and Social Care in England that publishes guidelines in four areas: * the use of health technologies withi ...
, United Kingdom. {{Endocrine system intervention Neurosurgery