Minimally Invasive Way to Remove Pituitary Tumors

Removing pituitary tumors through the nasal cavity rather than beneath the upper lip offers patients a minimally invasive alternative with similar results, less discomfort, and faster recovery, according to a new study published in the February 2003 issue of the Journal of Neurosurgery.

The older, sublabial approach involves an incision beneath the upper lip and extensive dissection in and around the nasal cavity. The procedure can cause long-term patient discomfort, including impaired nasal function and numbness of the upper lip and teeth.

In the new study, 100 consecutive patients who underwent the new endonasal procedure at the University of California, Los Angeles, Medical Center (UCLA, USA) later completed a questionnaire prepared by the researchers. Fourteen of these respondents had undergone prior sublabial procedures. Among the findings from the questionnaire were that remission rates with the new procedure were comparable to those found with the sublabial procedure. Twelve of the 14 patients with prior sublabial surgery preferred the new procedure.

The most common post-surgical complaints were nasal packing, removing of packing, and mouth breathing. Around three months after surgery, 83% of patients had no facial pain, 75% had no nasal congestion, 77% had no decreased nasal airflow, 73% had no decreased sense of smell, and 87% had no upper lip numbness.

"Our study suggests the direct endonasal approach to removing pituitary tumors offers a more direct surgical route, a low complication rate, and minimal postoperative discomfort,” said Dr. Daniel Kelly, associate professor of neurosurgery at the UCLA School of Medicine.




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