Endoscopic pituitary surgery in Amman: Doctors and Clinics

Endoscopic transnasal (transsphenoidal) pituitary surgery removes a tumour of the pituitary gland or of the region immediately around it through the natural corridor of the nose and the sphenoid sinus. A slim endoscope and fine instruments are used, so there is no craniotomy and no visible incision on the face or the scalp.

Surgery is usually considered when the tumour presses on the optic pathways and narrows the visual field, when it secretes hormones that disturb the whole body such as excess growth hormone or excess cortisol, when repeated imaging shows the lesion enlarging, or when there is sudden bleeding inside the tumour causing severe headache and rapid visual loss, which is treated as an emergency.

The decision is never taken by one doctor alone. A multidisciplinary team of neurosurgeon, endocrinologist, ENT surgeon, ophthalmologist and neuroradiologist reviews dedicated pituitary MRI, hormone profiles and formal visual field testing. Whether a particular person is a candidate is determined by clinical examination and by these results, not by reading a web page.

The limits of the operation matter as much as its aims. It does not necessarily restore vision that has been compressed for a long time, and it does not guarantee that hormone secretion returns to normal; some patients need hormone replacement for a long period. Removal is not always complete, particularly when the tumour extends into the cavernous sinus or wraps around arteries, so the plan may be completed with surveillance or with targeted radiotherapy. Prolactin-secreting tumours are usually treated with medication first rather than surgery, and the operation does not correct hormonal disorders whose cause lies outside the pituitary gland.

The procedure is performed under general anaesthesia and normally needs a short inpatient stay with close monitoring of consciousness, vision and fluid and salt balance, followed by hormonal review, repeat visual field testing and comparison imaging at intervals set by the treating team.