Pituitary gland - a gland of internal secretion, play a major role in the endocrine system. It is located in a recess base of the skull - the Turkish saddle. One of the main functions of the pituitary gland - the regulation of hormone balance in the body. Hormones, as catalysts are involved in various processes: in metabolism, sexual development, during sleep, mood and appetite. Violation of pituitary function may be due to a benign tumor of the prostate - a pituitary adenoma. Adenoma in the pituitary to secrete excess hormones, disrupting the balance and leading to various diseases: gigantism, acromegaly, Cushing's disease, infertility.
Diagnosis of pituitary adenoma
The decision to choose the treatment of pituitary adenomas in Israel neurosurgery clinic Assuta taken on the basis of instrumental studies:
- Diffusion-weighted MRI;
- diffusion tensor imaging;
- Computed tomography perfusion;
- IR spectrometry;
- laboratory diagnostics.
Get detailed information about the size of an adenoma, its distribution, location of the tumor in relation to the main vessels, the presence of secondary nodes adenoma patients is an individual treatment plan.
Treatment of pituitary adenoma in Israel
The clinics in the country applied conservative and surgical treatment of the disease.
Removal of pituitary adenoma
During surgery for a pituitary tumor removal Israeli neurosurgeons are using the latest neurosurgical navigation system based on CT and MRI techniques. Such systems make it possible to plan and monitor the progress of the operation, reduces surgical trauma, provide an opportunity to achieve good clinical results of surgical treatment and early rehabilitation of the patient.
Removal of pituitary adenoma clinic Assuta performed under general anesthesia and can be performed by two accesses:
- Top or craniotomy, when craniotomy is performed.
- Lower connection (trassfenoidalnym), which implies the implementation of the operation through the nasal cavity and paranasal sinuses.
The choice of surgical approach depends on many factors. Transcranial method used in removal of pituitary adenomas larger, multisite with growth in the propagation of the tumor in the skull structure. In clinic Assuta surgery to remove the adenoma of the pituitary by this method is carried out for 120 minutes. The period of stay of the patient in the clinic of the hospital for 3-5 days. In the complex treatment of pituitary adenomas in Israel also includes methods of reducing the risk of recurrence of the tumor - hormonal therapy and radiotherapy.
In 95% of cases apply transsphenoidal approach for removal of pituitary adenoma, it is a universal method. Endoscopic techniques are used separately or as a supplement.
There are three types of surgical intervention using a transsphenoidal approach:
- The surgeon makes an incision inside the nostrils so that then it was not noticeable. Discloses a submucosal cavity on the nasal septum to the level of the sphenoid sinuses. Extracts prevent the segments of the nasal partition, and later he set them in place. Small fragments conducts tumor removal. Then restores bone, restoring and consolidating remote sites previously. In places the cut sutures absorbable thread. At the end for faster healing imposes nasal dressing.
- The surgeon exposes the sphenoid sinus directly or produces a deep cut at the junction of bone and cartilaginous septum. In this case, it is not carried out the dissection septum cartilage, eliminating the need for overlaying the nasal dressing.
- The endoscopic method involves direct the front opening of the sphenoid sinus, in front of her parts are extracted septum. During surgery to remove a pituitary adenoma use: the system for bipolar and monopolar coagulation, modern intranasal drill, a light source, a digital video camera, a set of endoscopes, microsurgical technique. They can also be used Doppler study or fluoroscopic control for the safe removal of tumors of the cavernous sinus cavity.
Introduced through one nostril endoscope through another - special microsurgical technique whereby the small fragments are removed tumor. Using endoscopes angular enables to identify the presence of residual tumors, particularly along suprasellar area and wall of the cavernous sinus. At the end of surgery to remove the pituitary adenoma was reduced baffle bandage is not applied. The operation lasts 120 minutes, the period of hospitalization - 3 days.
Upon completion of the visual inspection and suprasellar endosellyarnyh structures to assess the results of surgery and homeostasis.
The combination of transcranial and transsphenoidal approach
In some cases the use of complex and transcranial transsphenoidal methods if adenoma tissue has grown into the base of the skull. The first stage is applied and removed transcranial access intracranial tumors and suprasellar segments. In the second stage use transfenoidalny access, removing the tumor through the sphenoid sinus structures of the skull base.
The cost of treatment of pituitary adenomas in Israel
We are conducting preliminary pricing:
- tumor diagnostic program will be about $ 2800 includes an MRI procedure (1470), a neurosurgeon consultation (560), blood tests.
- Price surgery to remove the tumors - 35.8 thousand dollars.