Revolution in neurosurgery in Peru: pituitary tumors are removed through the nose.

In Peru, a significant advancement in neurosurgery has made it possible to remove pituitary tumors through the nose, without the need to open the skull. This innovative technique, known as endonasal endoscopic surgery, represents a paradigm shift in the treatment of these tumors, which affect a considerable percentage of the population, with symptoms including headaches and visual problems. According to Dr. Jerson Flores, a neurosurgeon at the Anglo Americana Clinic, these tumors account for between 25% and 30% of all neoplasms at the base of the skull. The pituitary gland plays a crucial role in the hormonal regulation of the human body. It is responsible for secretions that affect multiple vital functions, and any alteration in its functioning can trigger serious consequences. Therefore, early detection and treatment of pituitary tumors is essential. Dr. Flores and his multidisciplinary team have addressed this issue with an approach that combines neurosurgery, endocrinology, and otolaryngology. Pituitary tumors are divided into two categories: functioning and non-functioning. The former have the ability to produce hormones in excess, which can result in a series of symptoms such as milk secretion in non-lactating women or fertility issues. Non-functioning tumors, although they do not produce hormones, can grow and press on nearby nerves, leading to complications such as vision loss. Dr. Cynthia Zegarra, an endocrinologist, emphasizes that early diagnosis allows for more effective and less invasive management of these tumors. The traditional surgical procedure, which required opening the skull, has been replaced by the endonasal endoscopic technique, which avoids large incisions and reduces the risk of complications. According to Dr. Diego Saldaña, an otolaryngologist, access to the tumor is achieved through the nose, minimizing damage to adjacent brain structures. This approach not only decreases the risks associated with surgery, such as infections and neurological damage but also accelerates the recovery process for patients. After surgery, it is common for patients to experience mild nasal congestion, similar to that of a cold. Most can resume their daily activities within approximately two weeks, provided they do not involve intense physical exertion. However, postoperative monitoring is crucial to ensure that complications do not arise, such as diabetes insipidus, which may require additional treatment. The possibility of recurrence of a pituitary tumor, although low, is something that doctors must consider. Dr. Flores explains that about 3% of tumors may reappear if complete removal is not achieved. In those cases, options such as radiation therapy are evaluated to control tumor growth and avoid additional surgical interventions. Detection of these tumors can be incidental, often discovered during examinations for other reasons, such as persistent headaches. Doctors emphasize the importance of being alert to any unusual symptoms, as early diagnosis can facilitate more effective and less invasive treatment. Education about the symptoms of pituitary tumors is essential to encourage timely medical attention. The impact of pituitary tumors is multifaceted, affecting not only the physical health of patients but also their emotional and social well-being. Collaboration among different medical disciplines, such as neurosurgery, endocrinology, and otolaryngology, has proven to be key in the successful management of these cases. Specialists emphasize that, despite the complexity of these tumors, the combination of advanced surgical techniques and proper follow-up can lead to positive outcomes and an improved quality of life for patients. Advancements in surgical techniques and multidisciplinary care are transforming the treatment of pituitary tumors in Peru. Endonasal endoscopic surgery not only represents a safer and less invasive approach but also offers hope to many patients who, after receiving an early diagnosis, can face treatment with a better outlook. Thus, a new horizon in neurosurgery opens up, promising to improve the lives of those facing this condition.