Not too long ago, surgery to remove a pituitary tumor involved a neurosurgeon opening up the scalp and moving the brain aside to reach the skull base. The incision, and the moving of the brain and many nerves and blood vessels, made for a complex surgery with a significant risk of complications. Today, thanks to major advances in surgical techniques and equipment, pituitary tumors can be removed through the nostrils with no visible incision, no trauma to the brain, and very low risk of complications.
Dr. Theodore Schwartz of the Weill Cornell Medicine Brain and Spine Center has been a pioneer in this transnasal surgery and has written and lectured extensively about it in addition to performing hundreds of procedures. This minimally invasive technique uses an endoscope — a tiny camera on a flexible tube — to provide high-quality 3D visualization of the tumor and the surgical path to reach it.
During the procedure, the neurosurgeon uses one of several possible routes through the nasal and sinus cavities to reach the skull base, where he uses endoscopic tools to remove the tumor. The next critical step is reconstructing the skull base to prevent leaks of cerebrospinal fluid (CSF), which had been one of the most common side effects of traditional surgery. CSF is the fluid that circulates throughout the brain and spinal column, and it’s important to seal off the skull base after surgery to keep the fluid from leaking. The Weill Cornell Medicine team uses a novel “gasket seal” to prevent leaks, and the Weill Cornell Medicine Brain and Spine Center has a remarkably low incidence of postsurgical CSF leaks.
Pituitary tumors are not uncommon, but they should be treated at major medical centers where the surgical team has extensive experience with these lesions.
Our Care Team
- Vice Chair for Clinical Research
- David and Ursel Barnes Professor in Minimally Invasive Surgery
- Professor of Neurosurgery, Neurology, and Otolaryngology
- Director, Center for Epilepsy and Pituitary Surgery
- Co-Director, Surgical Neuro-oncology
- Assistant Professor of Neurological Surgery
- Leon Levy Research Fellow
- Feil Family Brain and Mind Research Institute
- Assistant Professor of Neuroendocrinology in Neurological Surgery, Weill Cornell Medicine
- Director, Neurosurgical Radiosurgery
- Professor of Clinical Neurological Surgery
- Robert G. Schwager, MD ’67 Education Scholar, Cornell University
- Chief of Neurological Surgery, NewYork-Presbyterian Queens
- Co-director, Weill Cornell Medicine CSF Leak Program
- Chief of Neurological Surgery, NewYork-Presbyterian Brooklyn Methodist
- Alvina and Willis Murphy Associate Professor, Neurological Surgery
- Director, Brain Metastases Program
- Co-director, William Rhodes and Louise Tilzer-Rhodes Center for Glioblastoma
- Associate Professor of Clinical Neurological Surgery
Reviewed by: Georgiana Dobri, M.D.
Last reviewed/last updated: December 2020