This information is to give you an idea of what to expect from transsphenoidal surgery. Although each person’s experience is different, some general procedures are followed in the hospital that may be suitable for each patient.
If you have questions about your condition or surgery, ask a member of your healthcare team.
What is transsphenoidal surgery?
Transsphenoidal [trans-(going through) and sphenoid-(sphenoid sinus)] surgery is a procedure that allows the surgeon to travel from the nasal cavity to the pituitary gland and upper clivus.
Tumor or other abnormality in the pituitary area or skull base can be excised with this approach (fig. 1). A neurosurgeon and an otolaryngologist do this using special microsurgical tools. Since the pituitary gland is approached through the nose, there is no visible incision.
If necessary, a small incision can be made in the abdomen to obtain fat to fill the area occupied by the tumor.
Before surgery
Most people go to the hospital the morning of surgery. You will be asked to call the hospital the night before so that you can register on time. If you are already in the hospital or have arrived at the hospital the morning of the surgery, follow the instructions below to prepare for the surgery:
Take a shower and wash your hair from head to toe before the operation.
Do not eat or drink anything after midnight.
On the morning of surgery, continue to take your medication as prescribed. Take your medicine with a few sips of water so that you can swallow it easily.
If you have questions about your medications or these instructions, ask a member of the healthcare team.
During surgery
While in surgery, a nurse will take your belongings to your room. Your family will be told when your surgery started, when you were taken to the recovery room, and when you returned to your room.
After surgery
According to the surgical schedule for that day, your doctor will talk to you and your family some time after surgery. After you settle into your room, your family can come to visit you. The hospital stay after transsphenoidal surgery is generally around 24 hours.
While in your room after surgery, you will receive intravenous fluids. If you want the air to be humid, an air humidifier can be used.
Nurses will frequently check your blood pressure, heart rate, body temperature, muscle strength, vision, and adaptability to time and place. Nurses will also measure your fluid intake and urine output. They will give you a log pad and ask you to help keep track of any liquids you drink, other than the meals provided.
To measure your urine output, you will be asked to store your urine (in a bladder or collection pan in the toilet) each time you urinate. Notify nurses so they can record the amount after urinating.
After surgery, a small piece of gauze may cover your nostrils overnight. From time to time, a small amount of pinkish discharge may come from your nose. You may want to carry tissue paper with you for a day or two to dry up any discharge. If at any time you notice a clear, clear discharge from your nose or down the back of your throat, tell your healthcare provider immediately.
You will get out of bed on the day of surgery. The nurse will help you when you first get up. Nurses can take a bath if necessary, etc. It will also help you with other activities.
Pain or discomfort after surgery
Most people have only a mild headache or discomfort after nasal surgery. A nasal packing can be placed during surgery. This can cause pressure in your face, similar to what you feel when you get a headache or a cold. If an incision is made in your abdomen to obtain fat, you may experience moderate discomfort.
Ask the nurse for medication to relieve pain or any discomfort.
Activity restrictions after surgery
You may tire easily for the first few days after surgery. This is normal and will gradually improve. Talk to your healthcare provider about your activity restrictions, which may vary for different people.
Do not sneeze or blow your nose for two weeks after surgery. If you need to sneeze, sneeze with your mouth open, do not cover your nose.
Avoid any activity near the surgical site that may cause increased pressure.
Ask your healthcare provider about lifting information.
Do not strain yourself during bowel movements two weeks after surgery.
Discuss driving and getting back to work with your healthcare professional.
Other Instructions
You may have a discharge of blood or mucus from your nose for a few days after surgery. It’s normal. Dry this discharge with a tissue, do not blow it.
Post-surgical medications
Some headaches may last for several weeks. If necessary, you can take a non-aspirin pain reliever for the headache.
If you feel stuffy in your nose after surgery, you can take a decongestant.
In addition to pain medications and decongestants, you can take antibiotics.
Through the rate of involvement of the pituitary gland, the normal production of hormones in the pituitary gland after surgery can be determined. After surgery, you will have blood and urine tests to check hormone levels. You may also see an endocrinologist who will determine if you will need to take hormone medications after surgery.
Contact your healthcare professional
If you have questions about surgery, contact a member of your healthcare team.
If you have any of the following, call your healthcare provider right away.
Fever
Neck stiffness
Confusion – clouding of consciousness-
Headaches that become more persistent and serious
Clear, water from your nose discharge
Excessive urination
Lightheadedness
Nausea-vomiting
Other unusual symptoms
Health during work hours call your specialist. Outside of business hours, call a member of your healthcare team or call someone to drive you to the nearest emergency room.
