SEO Title (55 Characters): Why is Pituitary Adenoma Surgery Performed through the Nose?
SEO Description (140 Characters):
Hipofiz Adenomu Ameliyatı Neden Burundan Yapılır? Avantajları Nelerdir?
Pituitary adenoma surgery is the removal of masses in the pituitary gland, known as the “central hormone control center,” located at the base of the brain.
In current surgical practice, this procedure is performed using the nostrils, which is a natural opening, without opening the skull.
This method, which is called “Endoscopic Transsphenoidal Surgery” in the medical literature, is the most advanced technique that allows reaching the tumor without touching the brain tissue.
Hipofiz Adenomu Nedir? Neden Cerrahi Müdahale Gerekir?
Pituitary adenomas are tumors that originate from the pituitary gland and are usually benign.
These masses require surgical intervention for two main reasons: hormonal imbalances and mass effect.
Excessive hormone-secreting (functional) adenomas can lead to serious systemic diseases such as acromegaly, Cushing’s disease or prolactinoma.
Adenomas that do not secrete hormones but grow cause visual field loss by pressing on the visual nerves (optic chiasm) just above them.
Hipofiz Adenomu Ameliyatında Burun Yolu (Transsfenoidal Yaklaşım) Nedir?
The transsphenoidal approach is that the surgeon passes through the nasal cavity and reaches the air cavity called the sphenoid sinus, from where the pituitary gland is placed to the “sela turcica” (turkish bowel) area.
High-resolution endoscopes are used in this method.
The endoscope allows the surgeon to see the tumor at a very close distance, at a wide angle and in high light.
Hipofiz Ameliyatı Neden Burundan Yapılır?
The anatomical location of the pituitary gland is right behind the nasal cavity and in the lowest part of the brain.
This strategic location makes the nasal passage a natural corridor.
Beyin Dokusuna Zarar Vermeden Doğrudan Erişim
In classical surgeries (craniotomy) performed on the top or side of the skull, the surgeon must exclude or remove brain tissue to reach the pituitary gland.
In nose surgery, no contact is made with the brain tissue.
Since it proceeds directly from the bone base, the sensitive lobes of the brain are excluded from the operation.
Kafatası Açılmadan (Kraniyotomi Olmadan) Müdahale Şansı
In traditional brain surgeries, large incisions are made on the scalp and a bone window is opened from the skull.
There is no visible incision from the outside in the intervention made through the nose.
This provides a revolutionary convenience in terms of preserving body integrity.
Expert Note: The aim of pituitary surgery is not only to remove the tumor. The main reason for preferring the nasal route is to protect the healthy parts of the pituitary gland and the surrounding vital vascular-nervous structures with the highest sensitivity. This surgery is a high-tech discipline performed within a millimetric area.
Endoskopik Burun Yoluyla Hipofiz Ameliyatının Avantajları
Since the endoscopic technique offers a wider field of view and maneuverability than the microscopic method, it brings many advantages.
Kozmetik Avantajlar: Dikişsiz ve İzsiz Cerrahi
Since the surgery is performed completely through the nose, there is no scar on the face or scalp.
When the patients are looked at from the outside after the surgery, it is not clear that they have undergone an operation.
Kısa İyileşme Süresi ve Erken Taburcu Olma
Since the brain tissue is not damaged and the skull is not opened, the recovery process of the patient is very fast.
Patients can usually be discharged on the 2nd or 3rd day after surgery.
The patient’s return to social and business life is weeks earlier than classical surgeries.
Görme Fonksiyonlarının Korunması ve İyileşmesi
The tumor presses on the optic nerves from below.
Surgery performed through the nose also approaches the tumor from the bottom.
In this way, the pressure on the nerves is safely removed without the risk of damaging the nerves.
Many patients notice an increase in vision quality immediately after surgery.
Komplikasyon Risklerinin Minimuma İndirilmesi
The risks of cerebral hemorrhage, infection and neurological damage are significantly lower compared to craniotomy.
In particular, the image quality provided by the endoscope makes it easier to distinguish the tumor from healthy tissue.
| Özellik | Burun Yolu (Endoskopik) | Klasik Yol (Kraniyotomi) |
| Kesi Yeri | Burun içi (Görünmez) | Saçlı deri ve Kafatası |
| Beyin Ekartasyonu | Yok | Var |
| Hastanede Yatış | 2-3 Gün | 5-10 Gün |
| İyileşme Süresi | 1-2 Hafta | 4-8 Hafta |
| Görüntüleme | Geniş Açılı Endoskop | Mikroskop |
Ameliyat Süreci: Burundan Hipofiz Tümörüne Nasıl Ulaşılır?
The process begins with the preparation of advanced surgical navigation systems and endoscopic devices.
Introduction: Access is made through the mucosa by entering through the nostrils.
Sphenoid Sinus: The air space (sphenoid sinus) behind the nasal cavity is reached and the posterior wall is crossed.
Tumor Removal: The pituitary gland and tumor are made visible by opening the sela turcica bone. The tumor is discharged piece by piece with special micropowder.
Closure: When the surgery is over, the area is sometimes patched with the patient’s own tissues (fat or membrane) to prevent CSF (cerebrospinal fluid) leakage.
Kimler Burun Yoluyla Hipofiz Ameliyatı İçin Uygundur?
More than 95% of pituitary adenomas can be operated with this method.
Microadenomas: Hormone-secreting masses smaller than 1 cm.
Macroadenomas: Masses larger than 1 cm, pressing on the optic nerve.
Recurrent Cases: It can also be preferred in patients who have previously undergone surgery.
However, in very rare cases where the tumor is very common or the anatomy of the nose does not allow surgery, different approaches may be required.
Ameliyat Sonrası İyileşme Süreci ve Dikkat Edilmesi Gerekenler
The healing process is usually comfortable, but some critical rules need to be followed.
Fluid Balance: In the first days after surgery, urine output and water drinking amount are meticulously monitored (for diabetes insipidus risk).
Pressure Avoidance: It is forbidden to lift, blow or push for the first few weeks. This is to protect the healing of the cerebral membranes.
Hormone Control: Blood tests are performed to ensure that the pituitary gland performs its functions fully.
Expert Note: After the surgery, a slight feeling of fullness in the nose is normal. However, if a liquid such as clear water comes out of the nose, a physician should be consulted immediately. This may be a sign that cerebrospinal fluid is leaking from the patched area and requires rapid intervention.
This information is for general information purposes; it is recommended that you consult a health care provider for your condition.
Scientific Bibliography:
Endoscopic Endonasal Pituitary Surgery – Mayo Clinic Proceedings
Endoscopic vs Microscopic Transsphenoidal Surgery – PubMed/NIH
Pituitary Adenoma Management Guidelines – Endocrine Society
Frequently Asked Questions
Is there any deformity in the nose after pituitary surgery?
Since the endoscopic method is performed completely through the nostrils, no external incision is made and the nasal bone is not intervened. In this way, no aesthetic change or deformity occurs in the external appearance of the nose after the surgery.
What is the risk of damaging the brain during surgery?
In surgery performed through the nose, brain tissue retraction, that is, pulling the brain aside, is not performed. Since the surgeon proceeds directly from the base of the skull and reaches the tumor, the risk of damage to the brain tissue is much lower than in classical open surgeries.
How many hours does nose surgery take?
The duration of the operation may vary depending on the size of the tumor, its relationship with the surrounding tissues and whether it has previously undergone surgery. In general, endoscopic pituitary surgeries are completed between 1.5 and 3 hours.
Is nasal tampon used after surgery?
In modern endoscopic techniques, traditional large cloth tampons that prevent breathing are generally not preferred. In most cases, special materials are used that do not disturb the comfort of the patient, dissolve spontaneously or allow him to breathe.
Does the pituitary tumor recur after surgery?
In cases where the tumor is completely removed, the recurrence rate is quite low, but the type of adenoma and its spread to the surrounding tissues affect this situation. Monitoring the patients with hormone controls and MRI imaging at regular intervals in the postoperative period is critical in terms of managing this risk.
Source and Expert Knowledge: This article is written by Assoc. It was prepared in the light of Dr. Erdinç Özek’s 2026 current clinical protocols and operational experience in the field of endoscopic skull base surgery, pituitary adenomas and neuroendocrinology. Assoc. Prof. Dr. Erdinç Özek is a surgeon with advanced experience in closed brain surgeries performed through the nose (transsphenoidal) in Turkey.