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Transphenoidal resection
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Transphenoidal resection

My father, who is 67 years old, was diagnosed with Acromegaly and is scheduled for a transphenoidal resection to remove the tumor from his pituitary gland.  Can you please answer the following questions concerning this procedure: (1) How is the transphenoidal resection performed? I understand that the doctor will make a cut under my father's upper lip.  What happens after that?  (2) What kind of recovery can my father expect.  We have been told that he will be in ICU for one day and then will remain in the hospital for a few more days.  Will he need assistance at home and if so for how long? Will he be in a great deal of pain? (3) What can we, as his family, expect? Because the pituitary gland regulates a great deal in the body, will we need to be watchful for other hormone or system disturbances following the surgery? Will he be bruised and/or temporarily disfigured? I understand that after some sinus surgeries there can be a great deal of bruising.

Thank You.
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Dear Maggie:

The answers to your questions should come from the neurosurgeon who is doing the procedure.  He/She has seen the MRI, knows exactly where the tumor lies and therefore knows the exact stereotatic approach.  What was told to you?  The pituitary sit in a small cleft called the sella.  It lies behind the eye region.  Although easily approached, it should be done by someone who has had experience. They will likely lift the face, expose the sinus and bone, and then approach the pituituary.  It is impossible for anyone, especially over the internet what to expect.  It depends on the size, location, and invasion the tumor has taken.  It also depends on the surgeon.  Your father should be well medicated so he shouldn't be in much pain.  Again, I can't tell you what to expect without knowing about the above concerning the tumor.  The surgeon and the recovery staff will watch the functioning of the pituitary to see if there are co-morbidities to the surgery.

CCF Neuro MD
-7 Comments
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Hi Maggie,
I also have acromegaly. I have been through the TSH surgery twice and will gladly inform you on some details.  It will help take some of the fear away! The CCF dr is right as long as he is in the hands of a qualified surgeon he should do great.  I didn't experience any pain only discomfort, but the staff was ready and waiting with pain meds if needed. If interested please e-mail me at ***@****  
Trish
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Avatar_n_tn
Dear Trish:

Thank you for your comments and the willingness to listen and talk to someone else.

Sincerely,

CCF Neuro MD
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