Most operations to remove pituitary gland tumours are performed via the nasal cavity. This kind of surgery is called trans-sphenoidal surgery. Recent advances in technology have made it possible to operate with the use of endoscopes so that pituitary tumour removal is far less invasive and should not result in a noticeable scar.
Although uncommon, there are still cases where a craniotomy (surgery via the skull) may be necessary. This is usually due to a tumour that has spread to an area that cannot be accessed via the nostril. Your neurologist will explain what will happen if you fall into this rare category of patients.
While trans-sphenoidal surgery is less invasive, it is major surgery and will usually require a general anaesthetic. If you're about to have brain surgery to remove a tumour on your pituitary gland, read on to find out what you can expect immediately following the procedure.
What to Expect When You Wake Up
Once you've woken and have had time to recover from the anaesthesia, you should feel quite responsive and alert. Depending on how your operation went, you may wake up with packing in your nasal cavity, and your nose may feel sore. This packing is usually removed after a few days. If this is uncomfortable, then pain medication will be offered.
Machines will monitor your vital signs while you recover, and you will have a drip infusion of clear fluids as well as oxygen. You may also have a bladder catheter which stays in place for a few days to help your carers monitor your fluid balance—the fluids in and urine out. This is important as pituitary surgery may affect your ability to retain fluids for a while after surgery. If it does, this usually settles down within a few days. However, if it doesn't, hormone treatment may be offered to treat this condition (known as diabetes insipidus).
It's not uncommon to experience headaches or discomfort in the first few days following surgery. Your carers will prescribe painkillers to help with this. In addition to a blocked nose, you may notice some mucous discharge, blood clots and crusting. This is to be expected and nothing to feel alarmed by.
Make sure you report any leakage from your nose--this can be fluid that leaks out of your nose or a salty-tasting fluid that runs down the back of your throat. If this complication occurs, your surgeon may choose to pack the area where your tumour was--this will usually be done using a surgical sponge designed for the purpose. In some cases, your surgeon may choose to pack the area using a piece of fat from your abdomen or thigh. If this happens, there will be a small wound. This wound rarely causes complications and should heal well.
If your surgery was complication free, you should be able to get out of bed, to sit or walk to the bathroom, on the first day following surgery. Most people feel better with every day that passes, but don't feel alarmed if you feel tired or drained--everybody responds to surgery differently. Most importantly, you should notice an improvement in any symptoms caused by your tumour with every day that passes.