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hypophysectomy

Surgical removal of the pituitary gland (hypophysis). Indications: - tumors that resist other forms of treatment, especially craniopharyngioma - Cushing's syndrome resulting from pituitary adenomas - goal is partial rather than complete hypophysectomy Procedure: - incision is made beneath the patient's upper lip to enter the nasal cavity - a speculum is inserted, & special forceps are used to access & remove pituitary contents (tumor) Laboratory: - serum sodium & urine osmolality 1 week postoperatively [4] Complications: 1) hypopituitarism - diabetes insipidus - SIADH 2) cerebrospinal fluid (CSF) leakage 3) infection: abscess formation or meningitis 4) bleeding 5) nasal septal perforation 6) visual impairment 7) incomplete tumor removal Management: - patients with no pituitary function do quite well with appropriate hormone replacement [2,3] Notes: - also used without success in anti-aging experiments

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pituitary (hypophysis)

General

neurosurgery

References

  1. Stedman's Medical Dictionary 26th ed, Williams & Wilkins, Baltimore, 1995
  2. Encyclopedia of Surgery http://www.surgeryencyclopedia.com/
  3. Volz, J., U. Heinrich, and S. Volz-Koster. Conception and Spontaneous Delivery After Total Hypophysectomy Fertil Steril. 2002 Mar;77(3):624-5. PMID: 11872224
  4. Medical Knowledge Self Assessment Program (MKSAP) 18, American College of Physicians, Philadelphia 2018
  5. Kiran Z, Sheikh A, Momin SN et al SODIUM AND WATER IMBALANCE AFTER SELLAR, SUPRASELLAR, AND PARASELLAR SURGERY. Endocr Pract. 2017 Mar;23(3):309-317. PMID: 27967227
  6. Prete A, Corsello SM, Salvatori R. Current best practice in the management of patients after pituitary surgery. Ther Adv Endocrinol Metab. 2017 Mar;8(3):33-48. Review. PMID: 28377801 Free PMC Article