Transsphenoidal Surgery: What It Is, Who Needs It, and What to Expect

When a tumor grows on the pituitary gland, a small, pea-sized organ at the base of the brain that controls hormones. Also known as the master gland, it regulates everything from metabolism to stress response. If it develops a tumor, surgery is often the best option—and transsphenoidal surgery, a minimally invasive procedure to remove pituitary tumors through the nose and sphenoid sinus is the gold standard.

This isn’t open brain surgery. No scalp incisions. No drilling through the skull. Instead, a surgeon uses a thin endoscope—a camera on a flexible tube—inserted through the nostril to reach the tumor. It’s precise, fast, and often done in under an hour. Patients usually go home the next day. The approach works because the pituitary sits right behind the nasal cavity, making this path the shortest and safest route. It’s used for tumors like prolactinomas, corticotropinomas, and non-functioning adenomas. Not every pituitary tumor needs surgery, but when it does, transsphenoidal is the go-to.

Who benefits most? People with hormone-secreting tumors causing symptoms like unexplained weight gain, irregular periods, erectile dysfunction, or vision problems. Others with large non-secreting tumors that press on the optic nerve and blur vision. Even if the tumor isn’t causing symptoms, doctors may recommend removal if it’s growing. The success rate is high—over 90% for small tumors. Recovery is quicker than traditional surgery, with most people returning to normal activities in a week or two. Still, there are risks: temporary nasal congestion, headaches, or rare complications like CSF leaks or hormone imbalances. That’s why follow-up care with an endocrinologist matters.

What you won’t find in most brochures? How this surgery connects to other treatments. Many patients need hormone replacement afterward. Some need radiation if the tumor isn’t fully removed. Others take medication like cabergoline to shrink prolactinomas before surgery. And while transsphenoidal surgery is common in adults, it’s also used in teens and children with pituitary issues. The technique has evolved too—modern versions use 3D imaging and real-time navigation, making it safer than ever.

You’ll see posts here about how to prepare for surgery, what to expect during recovery, and how to manage hormone levels afterward. You’ll also find guides on understanding pituitary tumor types, why some patients need lifelong monitoring, and how to spot warning signs after discharge. These aren’t theoretical—they’re based on real patient experiences and clinical data. Whether you’re considering this surgery, supporting someone who is, or just trying to understand why your doctor recommended it, this collection gives you the clear, no-fluff facts you need.