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Introduction:A transsphenoidal endoscopic pituitary tumor excision is a specialised surgical procedure used to remove pituitary tumors located at the base of the skull. The pituitary gland is a small but essential gland situated at the bottom of the brain, responsible for producing hormones that regulate various bodily functions. Pituitary tumors can be benign or malignant and can lead to hormonal imbalances and other neurological symptoms. Transsphenoidal endoscopic surgery involves accessing the pituitary gland through the nose and sphenoid sinus, using an endoscope for visualisation and tumor removal. In this article, we will explore the symptoms, causes, diagnosis, treatment options, the cost of transsphenoidal endoscopic pituitary tumor excision in India, and conclude with its significance in neurosurgical care.Symptoms:The symptoms of a pituitary tumor can vary based on its size, location, and effects on hormone production. Common symptoms include:1.Headaches: Often persistent and may be severe.2.Vision changes: Blurred vision, double vision, or loss of peripheral vision.3.Hormonal imbalances: These can lead to a variety of symptoms, such as:a. Irregular menstrual periods or loss of menstrual periods in women. b. Erectile dysfunction and loss of libido in men. c. Growth abnormalities in children. d. Increased thirst and urination due to diabetes insipidus. e. Cushing's syndrome (weight gain, high blood pressure, and thinning skin). f. Acromegaly (enlargement of hands, feet, and facial features).Causes:The exact cause of pituitary tumors is often unknown. However, some factors may contribute to their development, including:1.Genetic mutations: Inherited genetic mutations may increase the risk of developing pituitary tumors.2.Hormonal imbalances: Certain hormone imbalances, such as those associated with multiple endocrine neoplasia type 1 (MEN1) or Carney complex, can lead to pituitary tumor formation.3.Radiation exposure: Previous radiation treatment to the head may increase the risk of pituitary tumors.4.Pituitary adenomas: Most pituitary tumors are benign (adenomas) and arise from the gland's cells.Diagnosis:Diagnosing pituitary tumors involves a combination of clinical evaluation, imaging tests, and hormone level assessments. The following diagnostic methods may be used:1.Magnetic Resonance Imaging (MRI): This imaging technique provides detailed images of the pituitary gland and surrounding structures, helping identify the tumor's location and size.2.Blood Tests: Hormone levels in the blood may be measured to assess for hormonal imbalances associated with pituitary tumors.3.Visual Field Testing: This test evaluates changes in peripheral vision, which can be affected by large pituitary tumors pressing on the optic nerves.Treatment:Transsphenoidal endoscopic pituitary tumor excision is a primary treatment option for most pituitary tumors. The surgical procedure involves the following steps:1.Anaesthesia: The patient is placed under general anesthesia to ensure they are unconscious and pain-free during the surgery.2.Nasal and Sinus Access: The surgeon inserts an endoscope through the nostril, reaching the sphenoid sinus, which is located just above the pituitary gland.3.Tumor Removal: The surgeon visualizes the pituitary tumor through the endoscope and carefully excises it, preserving surrounding healthy tissue.4.Hemostasis and Closure: After tumor removal, the surgical site is carefully controlled for bleeding, and the incision is closed.Transsphenoidal endoscopic surgery is minimally invasive, resulting in shorter hospital stays and faster recovery compared to traditional open cranial approaches.In cases where complete tumor removal is not possible or the tumor is malignant, additional treatment options may be considered:1.Medications: Certain medications can help manage hormone imbalances and tumor growth in certain types of pituitary tumors.2.Radiation Therapy: External beam radiation or stereotactic radiosurgery may be used to target the tumor and inhibit its growth.Cost of Transsphenoidal Endoscopic Pituitary Tumor Excision in India:The cost of transsphenoidal endoscopic pituitary tumor excision in India can vary based on several factors, such as the hospital's location, the surgeon's expertise, the type of tumor, and the overall complexity of the procedure. India's healthcare system offers high-quality medical services at a fraction of the cost compared to many other countries, making it an attractive destination for medical tourism. The cost-effectiveness, coupled with the availability of skilled neurosurgeons and advanced medical facilities, makes India a preferred choice for patients seeking transsphenoidal endoscopic surgery for pituitary tumors.Conclusion:Transsphenoidal endoscopic pituitary tumor excision is a highly effective and minimally invasive surgical procedure used to treat pituitary tumors at the base of the skull. It offers a safe and precise approach for tumor removal, allowing for shorter hospital stays and faster recovery compared to traditional open cranial surgery. Early diagnosis and timely intervention are crucial for successful outcomes. India's healthcare system provides access to high-quality neurosurgical care at a competitive cost, making it an excellent option for patients seeking advanced treatments for pituitary