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Pituitary surgery

Pituitary tumors/Neuroendocrinology

The pituitary surgery team deals with the clinical and scientific issues of sellar and perisellar processes – mainly pituitary adenoma, as well as colloid cysts, metastases, granulomas, chordomas, craniopharyngiomas and meningiomas. In particular, this working group aims to optimize the medical and surgical treatment of pituitary tumors. This also includes differentiated endocrinological diagnostics before and after surgery.

The overall coordination of both the preoperative and postoperative diagnostics (endocrinological function tests, neuroophtalmology) and the scheduling of the hospital stay and medical care is provided in the hospital's neurosurgical-endocrinological special consultation hours for pituitary surgery once a week on Wednesdays. For hormonal disturbances (hyper- and/or hypo-function) or conservative therapeutic approach there is a close cooperation with the medical-endocrine outpatient clinic.

Magnetic resonance image of a typical pituitary macro adenoma

Figure right side: Magnetic resonance image of a typical pituitary macro adenoma (green = adenoma, red = cerebral artery, yellow = displaced optic nerve).

Due to their size and hence space-consumption pituitary adenomas may cause headaches, and by pressure on the optic nerve may lead to vision disorders. Also a hypofunction of the hormone production (pituitary insufficiency) may occur due to the pressure on the pituitary gland.

The long-term follow-up of patients who were operated on pituitary tumors also takes place within the consultation hours for pituitary surgery in close collaboration with the medical-endocrinical outpatient clinic. There is a close cooperation with the departments of radiation oncology and neuro ophthalmology.

State of the art technical and instrumental equipment for surgical procedures in the area of the sella (surgical microscope, X-ray image viewer) exists. In most cases, pituitary tumors can be operated through the nose without opening of the skull. This allows a gentle and minimal invasive approach to the pituitary adenoma. For this purpose we are equipped with an ultra-modern operating room with integrated neuronavigation and endoscopy.

pituitary surgery

The figure above shows pituitary surgery with integrated neuro-navigation and endoscopy

By means of long-term clinical studies the frequency of recurrence of these tumors after complete and incomplete resection can be determined depending on various prognostic factors.

Furthermore this working group is performing studies on proliferation and growth behavior of pituitary adenomas.

There is a close cooperation with the (working group on endocrinology at the Department of Medicine (Prof. Dr. Seufert)) and the Freiburg Endocrinology Research Group (FREAK).