Minimally Invasive Technique Eradicates Recurring Pituitary Abscess

In this intraoperative video, watch UCSF neurosurgeons Ezequiel Goldschmidt, MD, PhD, and Peter Sun, MD with Patricia Loftus, MD, from the Otolaryngology Department surgically evacuate a sellar abscess of the pituitary gland in a pediatric patient. The 9-year-old presented with meningitis and vision problems and was found to have recurrent pituitary abscess despite two prior operations and a prolonged course of antibiotics.

Often called the “master gland” and located at the base of the brain, the pea-sized pituitary gland controls the other glands in the endocrine system. A pituitary abscess is a rare disorder where pus builds up inside the gland. In children, pituitary dysfunction can halt normal growth and affect puberty. 

Using an endoscopic endonasal infrasellar approach, a minimally invasive technique that allows the surgical team to operate through the nose, the surgeons were able to fully evacuate the abscess. Then they used a piece of the nose lining, called nasal mucosa, to connect the nasal cavity to prevent the abscess from reoccurring. Following the operation, the patient had no visual complaints and was taken off antibiotics eight weeks later.