Neurosurgeon and otolaryngologist work together to remove tumor of pituitary gland

Feb 3 2017

After experiencing bad headaches and double vision, Kris Johnson was diagnosed with a pituitary adenoma, a tumor of the pituitary gland at the base of the brain.

The tumor was in an extremely delicate location, surrounded by critical brain structures. But Loyola Medicine otolaryngologist Chirag Patel, MD, and neurosurgeon Anand Germanwala, MD, were able to remove the tumor without damaging surrounding tissues or even touching the brain. The tumor was removed through the nostrils, and there were no external incisions. Ms. Johnson has fully recovered and no longer has headaches or double vision.

"You talk about Loyola treating the human spirit, and that's exactly what they did," Ms. Johnson said.

Ms. Johnson's case illustrates the benefits of Loyola Medicine's multidisciplinary approach to removing pituitary adenomas and performing other surgeries at the base of the brain.

A pituitary adenoma is a tumor of the pea-sized pituitary gland located in the center of the brain behind the nose and eyes. The pituitary gland is known as the master gland because it produces hormones that control other glands. It is surrounded by blood vessels that supply the brain and nerves responsible for vision and eye movement.

Dr. Patel opened the sinuses, removed bone and created a pathway to the brain. Drs. Patel and Germanwala then worked together as a team to remove the tumor. They used advanced technology such as small high-definition cameras and a GPS system for the brain.

"I'm the nose expert and Dr. Germanwala is the brain expert," Dr. Patel said. "Why do anything alone when you have two experts who can work together?"

Dr. Germanwala said he and Dr. Patel do approximately four or five cases each month similar to Ms. Johnson's.

"She put a lot of faith and trust in us," Dr. Germanwala said. "That is something we always cherish."

Loyola Medicine's renowned Center for Cranial Base Surgery treats patients with extensive tumors at the undersurface of the brain, an area that borders on the brain, ears, eyes, nose, throat and neck.

Loyola's neurosurgeons, otolaryngologists and other specialists each bring unique expertise to treat cranial base tumors, which often surround the nerves and blood vessels traveling to or from the underside of the brain. The center has developed innovative methods for the safe and complete removal of difficult-to-reach cranial base tumors and lesions that might otherwise be considered inoperable.

Loyola strives to coordinate diagnosis, surgery techniques and other therapies to achieve the best possible outcomes. Treatment options may include state-of-the-art neuroradiology, laser and intraoperative microscopic techniques, including endoscopic skull base surgery and use of a fully equipped speech and swallowing laboratory.