Question 1

What is the Meaning of Transsphenoidal Surgery?

Accepted Answer

Transsphenoidal surgery is a neurosurgical procedure removing tumors or lesions from the pituitary gland and sella turcica. Access through the nasal cavity and sphenoid sinus offers a direct, minimally invasive route to the brain's base, avoiding cranial incision. This technique addresses conditions affecting this crucial endocrine organ.

Question 2

What is the Context of Transsphenoidal Surgery?

Accepted Answer

The pituitary gland, within the sella turcica at the skull base, is central to the endocrine system, regulating growth, metabolism, and reproduction. Pituitary adenomas often arise here, disrupting hormonal balance or compressing adjacent neural structures, notably the optic chiasm. These tumors lead to diverse clinical manifestations.

Question 3

What is the Significance of Transsphenoidal Surgery?

Accepted Answer

This surgical intervention is the primary treatment for many pituitary adenomas, especially those causing hormonal excess or neurological compression. Successful transsphenoidal surgery normalizes aberrant hormone levels, alleviating symptoms like Cushing's disease or acromegaly. It often mitigates mass effect symptoms, significantly improving patient health and functional status.

Question 4

What is the Mechanism of Transsphenoidal Surgery?

Accepted Answer

The procedure accesses the sphenoid sinus via the nostril. An opening is created in the sella turcica's anterior wall, exposing the pituitary gland. Using microscopic or endoscopic visualization with specialized instruments, the surgeon dissects and removes the tumor. The goal is complete tumor resection, preserving healthy tissue and vital neurovascular structures.

Question 5

What is the Application of Transsphenoidal Surgery?

Accepted Answer

Transsphenoidal surgery is widely applied for managing sellar and parasellar lesions. Its primary use is resecting pituitary adenomas, both functioning (hormone-secreting) and non-functioning (mass effect). The technique also treats Rathke's cleft cysts and some craniopharyngiomas. Patients undergo comprehensive pre-operative and post-operative hormonal monitoring.

Question 6

What is the Metric of Transsphenoidal Surgery?

Accepted Answer

Efficacy is assessed through objective clinical, biochemical, and radiological metrics. Post-operative endocrine panels monitor specific hormone levels (cortisol, IGF-1, prolactin) to confirm remission or identify deficiencies. Visual field examinations quantify vision improvement. Serial MRI scans evaluate tumor removal and detect recurrence.

Question 7

What is the Risk of Transsphenoidal Surgery?

Accepted Answer

Transsphenoidal surgery carries potential risks. Common complications include cerebrospinal fluid (CSF) leakage (requiring repair) and diabetes insipidus (needing desmopressin). Hypopituitarism, requiring lifelong hormone replacement, is another concern. Less frequent but serious risks include hemorrhage, infection, visual disturbances, or nasal complications.

Transsphenoidal Surgery

Meaning

Context

Significance

Mechanism

Application

Metric

Risk

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