Tuesday, August 25, 2009

Appointment with the Neurosurgeon

On August 12, I had my appointment with the neurosurgeon at Washington University. My endocrinologist is also up there. The appt. went very well. I was ready for him as well. I had my list of questions and Scott there to back me up. I kept having him read the questions to ask the doctor. I just knew I would forget, or get caught up in the words and not be able to spit them out. Honestly there wasn't even a need for the wonderful list of questions courtesy of Linda P at www.cushings-help.com/lindap-tips.htm . Obviously for my own personal info there was an absolute need for them. Dr. C went straight down the list without me ever pulling it out.

We looked at the MRI (first time I had seen it) and went over the PSS results, the symptoms, and a quick neuro exam which was follow the finger, touch your nose kind of thing. Dr. C went right into "this is what we can do". The surgery is called an endoscopic transsphenoidal resection of the pituitary. By the end of the appt. I had no questions for him, except how soon? And well... here I am 1 DAY awayfrom my surgery.

Transsphenoidal surgery is performed to remove tumors from the pituitary gland, sellar region, and sphenoid sinus of the skull. The surgeon approaches the pituitary through the nose. The surgery can be performed with a microscope or more commonly with an endoscope in a minimally invasive technique. Pituitary tumors cause a variety of hormone problems and can grow to large size, compressing important nerves and arteries at the base of the brain. When this occurs, surgery is needed to remove the tumor, especially when vision is at risk. Tumor removal often reverses endocrine problems and restores normal hormone balance.

What is transsphenoidal surgery?
Transsphenoidal literally means “through the sphenoid sinus.” It is a surgical procedure performed through the nose and sphenoid sinus to remove pituitary tumors (Fig. 1). Transsphenoidal surgery can be performed with a microscope, endoscope, or both. The procedure is often a team effort between neurosurgeons and ear, nose, and throat (ENT) surgeons. A traditional microscopic technique uses a skin incision under the lip and removal of a large portion of the nasal septum so that the surgeon can directly see the area. A minimally invasive technique, called endoscopic endonasal surgery, uses a small incision at the back of the nasal cavity and causes little disruption of the nasal tissues. The ENT surgeon works through the nostrils with a tiny camera and light called an endoscope. In both techniques, bony openings are made in the nasal septum, sphenoid sinus, and sella to reach the pituitary. Once the pituitary is exposed, the neurosurgeon removes the tumor. www.mayfieldclinic.com

I meet with the ENT surgeon on the 26th at 7:30am and then at 2:30 in the afternoon I go for the Stealth MRI and Stealth CT. >>

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