hypophysectomy

Introduction

Surgical removal of the pituitary gland (hypophysis).

Indications

• tumors that resist other forms of treatment, especially craniopharyngioma
• Cushing's syndrome resulting from pituitary adenomas
• goal is partial rather than complete hypophysectomy

Laboratory

• serum sodium & urine osmolality 1 week postoperatively

Procedure

• incision is made beneath the patient's upper lip to enter the nasal cavity
• a speculum is inserted, & special forceps are used to access & remove pituitary contents (tumor)

Complications

• hypopituitarism
  • diabetes insipidus
  • SIADH
• cerebrospinal fluid (CSF) leakage
• infection: abscess formation or meningitis
• bleeding
• nasal septal perforation
• visual impairment
• incomplete tumor removal

Management

• patients with no pituitary function do quite well with appropriate hormone replacement

Notes

• also used without success in anti-aging experiments

More general terms

• neurosurgery

Additional terms

• pituitary (hypophysis)