Pituitary & Skull-Base Surgery
Pituitary and skull-base surgery treats tumours of the pituitary gland and the base of the skull. Most pituitary tumours are removed through the nose using an endoscope, with no external incision or head shaving. At FHI, neurosurgeons work alongside endocrinology and ENT to protect your hormones and vision throughout.
Medically reviewed by the Florence Healthcare medical team · Last reviewed June 2026
Overview
Pituitary and skull-base surgery removes tumours of the pituitary gland — most commonly benign pituitary adenomas — and other lesions sitting at the base of the skull, such as meningiomas or craniopharyngiomas. The great majority of pituitary tumours are reached through an endoscopic endonasal transsphenoidal approach: the surgeon passes a slim endoscope through the nostril and the sphenoid sinus to reach the gland, so there is no external incision and no need to shave the head. Surgery is usually advised when a tumour presses on the optic nerves and threatens vision, over-produces hormones (as in acromegaly, Cushing's disease, or prolactinomas not controlled by medication), or continues to grow. Larger or more complex skull-base tumours may instead need a craniotomy, which the team will explain clearly if it applies to you.
Because the pituitary gland governs many of the body's hormones, this is genuinely team surgery. At FHI, neurosurgeons work closely with endocrinology and, for the nasal route, ENT specialists; hormone levels are measured before and after the operation and replacement is given when needed. A dedicated international patient coordinator is your single point of contact, arranging a remote review of your MRI and hormone results by the surgical team before you travel, and providing a transparent, itemized cost estimate with no hidden charges.
Who is a candidate?
- You have a pituitary adenoma or skull-base tumour confirmed on MRI that is growing, pressing on nearby structures, or affecting your vision.
- Your tumour is over-producing hormones — for example causing acromegaly or Cushing's disease — or is a prolactinoma that medication has not controlled.
- You have new or worsening vision changes thought to be caused by pressure on the optic nerves.
- You and the team have weighed surgery against medication or active monitoring, and surgery offers the clearest benefit.
- You are well enough for general anesthesia, as confirmed by pre-operative assessment.
- You can attend the hormone and imaging follow-up that this surgery requires, in person or coordinated with your doctor at home.
What happens
- 1
Assessment & imaging
Before you travel, the team reviews your MRI scans and hormone blood tests remotely and discusses the likely approach with you. On arrival you complete any additional imaging, eye and visual-field checks, and a full endocrine work-up so the plan is confirmed and personalised.
- 2
The operation
Under general anesthesia, the surgeon most often reaches the tumour endoscopically through the nose and sphenoid sinus, removing it with no external incision. For larger or more complex skull-base lesions a craniotomy may be used. The endocrine and ENT teams are involved throughout to protect hormone function and the nasal passages.
- 3
Early recovery
You are monitored closely in hospital for hormone balance, fluid levels, and any nasal drainage. Hormone replacement is started if needed. Many people feel nasal congestion for a time after the endonasal approach; the team guides you on gentle nasal care and what to avoid.
- 4
Recovery & follow-up
Most people return to everyday activities within a few weeks, with heavy exertion and nose-blowing restricted while the area heals. Repeat hormone tests, an MRI, and visual-field checks are arranged to confirm the result, and your coordinator helps share these reports with your doctor at home.
Benefits
- Most pituitary tumours are removed through the nose, with no external incision and no head shaving.
- Relieving pressure on the optic nerves can halt and often improve vision loss.
- Removing or reducing hormone-producing tumours can correct conditions such as acromegaly and Cushing's disease.
- A combined neurosurgery, endocrinology, and ENT team manages both the tumour and your hormones.
- Remote review of your scans and hormones before travel, with a clear, itemized estimate.
Risks & considerations
- Hormone changes are possible: some people need temporary or long-term hormone replacement, which is monitored and adjusted by endocrinology.
- A leak of cerebrospinal fluid (CSF) through the nose can occur and may require additional treatment or repair.
- Diabetes insipidus — a temporary or lasting change in water balance and thirst — can develop and is treatable.
- Nasal symptoms such as congestion, crusting, or altered smell are common early on and usually settle.
- As with any surgery near the brain, there are risks of bleeding, infection, and, less commonly, injury to nearby nerves or vessels.
- Not every tumour can be removed completely; some may need further surgery, medication, or radiation therapy.
Conditions this treats
Where it is performed
This procedure is delivered by our Neurological Sciences Center.
Learn more before you decide
Provider-reviewed guides on the related conditions, symptoms and tests in our Health Library.
Pituitary & Skull-Base Surgery — frequently asked questions
Most pituitary tumours are removed endoscopically through the nose and the sphenoid sinus, so there is no external incision and your head is not shaved. Larger or more complex skull-base tumours may need a craniotomy instead; if that applies to you, the surgeon will explain exactly what it involves beforehand.
Because the pituitary controls many hormones, your levels are checked before and after surgery. Some people need hormone replacement for a time, and a few need it long term. Our endocrinology team monitors your levels closely and adjusts any replacement so your hormones stay balanced.
When a tumour is pressing on the optic nerves, removing it relieves that pressure and can stop further loss and often improve vision. How much sight returns depends on how long and how severely the nerves were affected, which is why earlier treatment generally gives the best outcome. Your vision is checked before and after surgery.
After reviewing your MRI and hormone results, we provide a transparent, itemized estimate covering the surgery, hospital stay, and team care, with no hidden charges. The hospital stay is typically a few days, depending on your tumour and the approach used. We never quote a price before reviewing your case.
Yes. You can send your MRI scans and hormone blood tests to your coordinator, and the surgical and endocrinology teams review them remotely. This lets us confirm whether surgery is appropriate, discuss the likely approach, and prepare your personalised plan and estimate before you commit to travelling.
Related treatments
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