What is trans-sphenoidal surgery for a pituitary tumour?

Trans-sphenoidal surgery is an operation to remove a pituitary tumour through the nose — without any cut on the head or face. The surgeon reaches the pituitary gland, which sits just behind the nose at the base of the brain, by passing instruments through a nostril and the sphenoid sinus (a hollow space in the skull). Most modern cases are done with a thin telescope called an endoscope, so it is often described as endoscopic pituitary surgery. Because it avoids opening the skull, recovery is usually quicker than open brain surgery. It is the standard approach for most pituitary adenomas that need surgery.

Is pituitary tumour surgery through the nose painful?

The surgery itself is done under general anaesthesia, so you feel nothing during the operation. Afterwards, most people describe the main discomfort as a blocked, stuffy nose rather than sharp pain — similar to a heavy cold — because the nasal passages are healing. There may be a mild headache and a need to breathe through the mouth for a short while. Nasal packing, if used, is usually removed within a day or two. Pain is generally well controlled with simple medication, and most patients are surprised at how manageable recovery is compared with what they feared.

How long is recovery after endoscopic pituitary surgery?

Many patients go home within two to four days if there are no complications, and return to light activity over a few weeks. The nose can stay stuffy for several weeks as it heals, and you will be advised to avoid nose-blowing, heavy lifting, and straining for a period to protect the repair. Hormone levels and vision are checked after surgery, and some patients need temporary or long-term hormone tablets. Your CION team will map out a clear follow-up plan — including a follow-up MRI — so you know exactly what to expect at each stage.

Does CION perform trans-sphenoidal surgery in-house?

CION does not have an in-house neurosurgeon, so the operation itself is coordinated with our accredited neurosurgical and ENT partners who are experienced in endoscopic skull-base surgery. What CION delivers directly is the surrounding care that decides your outcome: a multidisciplinary tumour board to confirm whether surgery is right, endocrine (hormone) assessment and management, molecular and pathology review of the tissue, radiation therapy (including coordinated radiosurgery) when needed, imaging, and long-term follow-up. We make sure surgery, hormones, imaging, and oncology work as one plan rather than disconnected steps.

When is radiation used instead of, or after, pituitary surgery?

Surgery is the first choice for most pituitary tumours that need treatment, but radiation has an important role. It is considered when a tumour cannot be fully removed, when it grows back after surgery, or when a patient is not suited to an operation. Modern options include highly focused stereotactic radiosurgery delivered over one or a few sessions, coordinated as part of specialist care. Some tumours — particularly prolactinomas — are often controlled with medication alone and may not need surgery at all. CION's tumour board weighs surgery, radiation, and medication together for each person.

What are the risks of trans-sphenoidal pituitary surgery?

Trans-sphenoidal surgery is generally safe in experienced hands, but every operation carries risks. The main ones include a leak of the fluid that surrounds the brain (a CSF leak), which may need a further repair; changes in hormone levels that can require replacement tablets; and, less commonly, effects on vision or on the gland that controls water balance (causing extra thirst and urination, usually temporary). Nasal crusting and stuffiness are common but settle. Careful pre-surgery planning, hormone testing, and follow-up — all coordinated by CION alongside the surgical team — are how these risks are minimised and managed early.