Procedure: Endoscopic Endonasal Approach


Mr A, a gentleman of middle age, suddenly developed severe intense headaches on waking up one morning. This headache was more severe than anything he had ever experienced. Within a short time, the pain increased and simply got worse. After visits to a local doctor and some injections there was no change and in fact his symptoms intensified to the point where he began to vomit and the vision in his right eye was beginning to get hazy.

Mr. A's Preoprerative ScanMr. A's Preoprerative ScanMr. A's Preoprerative ScanMr. A's Preoprerative Scan

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On the recommendation of a friend he visited Dr Arvind Bhateja – head of the Department of Neurosurgery at Sita Bhateja Speciality Hospital. Dr Bhateja immediately suspected something very wrong and ordered a CT scan of the head.

The scan revealed a pituitary tumor which had undergone a change known as ‘apoplexy’ – the sudden ‘death’ of the tumor with bleeding within it, leading to severe headache and compression of the optic nerves (nerves of vision). This was a surgical emergency!


Mr A was immediately admitted and an MRI scan and other necessary tests were done. The following morning, the team of Dr Arvind Bhateja and Dr Vinay BR (ENT surgeon) were approaching the tumor by means of an endoscope through the Mr A’s nose. In a little under 3 hours the tumor was successfully removed completely with no complications during the surgery.


Mr A made an excellent recovery and was discharged a few days later with no external scarring whatsoever.

This case again highlights the excellent outcomes that can be achieved through meticulous surgical technique and the use of the most modern technologies to treat complex brain afflictions.

Mr A's Post operative ScanPituitary Tumour Post operative Scan

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Pituitary tumors are slowly growing non cancerous tumours which cause the pituitary gland to make either too few or too much hormones. Studies show that upto 20% of people have pituitary tumors. When they grow large without any warning, they may compress the optic nerves (the nerves of vision) leading to partial or complete blindness.

At times, pre-existing tumors in the pituitary gland may suddenly bleed leading to a potentially fatal condition known as pituitary apoplexy which warrants immediate investigation and treatment. At SBSH, we have treated several patients with pituitary tumors with and without apoplexy with results comparable to the best centers in the world.

These tumors present with painless loss of vision, visual field defects, symptoms of hormonal imbalance, headache and vomiting. In cases of apoplexy, the symptoms range from sudden, severe headache, vomiting, visual loss or paralysis of eye movements to loss of consciousness.

Read more about our pituitary tumor program here: /tumours-pituitary-gland-skull-base/

These tumors can almost always be safely and completely removed using an endoscopic approach through the nose.

If you’ve any of these symptoms, you need to see a neuro surgeon and get proper diagnosis. You can contact Sita Bhateja Hospital, Bangalore for more details –

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