Pre-op Management
This imaging study is used to visualize a pituitary adenoma before surgery.
What is MRI?
This surgical approach accesses the pituitary gland through the nasal cavity.
What is the trans-sphenoidal approach?
This condition is characterized by excessive urination and is the most common early complication after surgery.
What is diabetes insipidus?
Patients often require lifelong monitoring of these systems after pituitary surgery.
What are hormone levels/endocrine function?
This condition results from decreased ADH and causes excessive urine output.
What is diabetes insipidus?
This visual deficit is often seen pre-operatively due to compression of the optic chiasm.
What is bitemoral hemianopsia?
This sinus is passed through to reach the pituitary gland.
What is the sphenoid sinus?
This medication is used to treat post-operative diabetes insipidus.
What is desmopressin?
This imaging modality is used long-term to monitor for tumor recurrence.
What is MRI?
This condition results from excess ADH and leads to hyponatremia days after surgery.
What is SIADH?
This hormone axis must be stabilized pre-operatively to prevent life-threatening hypotension during surgery.
What is the HPA axis (Hypothalamic–Pituitary–Adrenal axis)?
This bony structure houses the pituitary gland and is opened during surgery.
What is the sella turcica?
Clear nasal drainage after surgery may indicate this serious complication.
What is a CSF leak?
This condition refers to decreased production of pituitary hormones after surgery.
What is hypopituitarism?
This infection is a risk due to CSF leakage after surgery.
What is meningitis?
Patients are instructed to avoid this action post-operatively to prevent increased intracranial pressure and CSF leak.
What is nose blowing?
This nearby vascular structure poses a major bleeding risk if damaged during surgery.
What is the internal carotid artery?
This electrolyte abnormality is commonly seen in diabetes insipidus.
What is hypernatremia?
This hormone replacement is commonly required due to loss of pituitary stimulation of the adrenal glands.
What is hydrocortisone?
Damage to this structure can cause cranial nerve deficits due to its location lateral to the pituitary.
What is the cavernous sinus?
This protein regulates the rate-limiting step of steroid hormone synthesis and can aid in evaluating endocrine stability pre-op.
What is StAR protein?
These cranial nerves lie in the nearby cavernous sinus and are at low risk of being damaged.
What is III, IV, V1, V2, and VI
This hormone must be replaced urgently post-operatively to prevent adrenal crisis.
What is cortisol (hydrocortisone)?
This hormone axis involves LH and FSH and may be affected long-term, leading to fertility issues.
What is the gonadal axis?
A patient 2 days post trans-sphenoidal surgery presents with confusion and low sodium levels.
What is SIADH?