When a pituitary tumor begins affecting your vision, your hormones, or your daily quality of life, finding the right team matters. At Princeton Brain, Spine & Orthopedics (PBSO), our fellowship-trained neurosurgeons offer advanced transsphenoidal pituitary surgery (TSS) — a minimally invasive approach that removes tumors through the nasal passage, with no visible scarring and a faster path back to the life you love.
For nearly two decades, PBSO has been a trusted destination for patients across New Jersey and Eastern Pennsylvania seeking expert neurosurgical care. Our board-certified surgeons have completed extensive subspecialty training in complex cranial and skull base procedures, and they partner closely with endocrinologists, neuro-ophthalmologists, and imaging specialists to coordinate every stage of your care. From your first consultation through long-term follow-up, you can expect precise diagnostics, clear guidance, and a patient-centered approach grounded in clinical excellence and compassion.
Procedure & Recovery Overview
Pituitary tumors are growths that develop in the pituitary gland. Though most are benign (not cancerous) and grow slowly without spreading to other locations, these tumors can put dangerous pressure on the pituitary gland or optic nerves. In some cases, this pressure leads to headaches, vision loss, and hormone deficiency or overproduction.
Some non- or less-symptomatic pituitary tumors can be carefully observed or treated with hormone medications. When more aggressive treatment is called for, your Princeton Brain, Spine & Orthopedics medical team may recommend an endoscopic procedure called transsphenoidal surgery (TSS).
What Happens During Transsphenoidal Pituitary Surgery?
Your PBSO neurosurgeon performs transsphenoidal surgery through the sphenoid sinus — a hollow skull space beneath the brain and behind the nasal passages. Using an endoscopic camera, microscope, small light, and precision instruments, the surgeon enters the sinus through the nose to remove the mass. In some cases, your neurosurgeon may also make a small incision under the upper lip or in the nasal septum. After opening the sphenoid sinus to expose the pituitary, the surgeon removes the tumor. In many cases, tumor resection results in a successful reversal of headaches, hormone symptoms, and vision issues.
In addition to pituitary adenoma, PBSO may use an endoscopic TSS procedure to remove other types of abnormal tissue:
- Chordoma
- Adenoma
- Craniopharyngioma
- Rathke’s (benign) cleft cyst
When a tumor is too large or complex for the transsphenoidal approach, your neurosurgeon may recommend a craniotomy.
Transsphenoidal surgery may not be appropriate for removing large tumors, but it can be safely used for most small masses (up to 3 cm) that have not extended into surrounding tissue. Advantages of TSS over traditional surgery include:
- Reduced chance of brain injury (no craniotomy is needed)
- Lower blood loss
- No visible scarring
- Reduced rate of major complications
- Shorter hospital stay with less pain
After TSS, it is common to experience nasal congestion, headache, or nausea due to swelling and discharge from the nose. Your medical team may recommend medications such as pseudoephedrine to ease these symptoms. An endocrinologist may be included in your clinical team and will be called upon to check pituitary hormone levels after surgery. He or she may recommend hormone replacement medications when pituitary levels are inadequate. After TSS, you will likely receive a brain MRI to assess the completeness of tumor removal.
Why Choose Princeton Brain, Spine & Orthopedics
Patients across New Jersey and Eastern Pennsylvania choose PBSO because our team combines world-class neurosurgical expertise with a personal, relationship-driven approach to care. Our fellowship-trained surgeons have performed transsphenoidal procedures for some of the region’s most complex pituitary cases, collaborating with leading hospitals and a multidisciplinary network of endocrinologists, neuro-ophthalmologists, and rehabilitation specialists.
Every patient receives a tailored treatment plan, clear answers at each step, and the reassurance that comes from working with a practice known for clinical excellence, integrity, and compassion — values we’ve upheld since our founding nearly 20 years ago.
Learn More or Schedule an Appointment
To learn more about transsphenoidal surgery or other treatments and interventions for pituitary tumors, contact our offices or take advantage of the resources on our website.
To schedule a transsphenoidal surgery consultation or request information about PBSO’s spinal, cranial, and neurosurgical providers, call (888) 741-7272. For your convenience, you can also contact PBSO online, and a member of our team will respond quickly to answer your questions.
