Miss Diagnosis: A Step In the Right Direction

Wednesday, April 8, 2009

A Step In the Right Direction

This is from my email box this morning.
Mrs. Bibby,
I've exchanged messages with Dr. Friedman. Expect to talk to him soon and will get back to you right away. I have reviewed your daughter's records in more detail, and your decision to proceed with the bilat adrenalectomy does seem very appropriate.
BV
This seems like we are making progress anyway. I wish I knew his definition of "soon".

1 comment:

judycolbyApril 8, 2009 at 2:21 PM
Sounds very promising. let's hope that his idea of soon is what ours is, about a week or less.
ReplyDelete
Replies

Add comment

Transphenoidal Pituitary Surgery- From the UCSF web site

What happens during surgery?
The surgical removal of the pituitary adenoma is performed by a technique called a transsphenoidal operation. The word 'transsphenoidal' describes the path the surgeon follows to reach the pituitary gland. The word comes from 'trans', meaning 'to cross or pass through', and 'sphenoid', the name of the cavity (the sphenoid sinus) that is passed through to reach the pituitary gland. Newer techniques and improvements in technology now allow removal of these tumors without the need for an incision under the lip or within the nostril. The surgeon begins the approach by entering through the nostril on one side. The surgeon uses a brilliant fiber optic light to illuminate the internal anatomy, a microscope to magnify the area of surgery to 12 times the actual size, and very tiny microsurgical instruments especially designed for this particular operation. The surgeon guides the surgical instrument into the nasal cavity and an opening is made in the sphenoid bone. The sphenoid sinus is entered, and then an opening is made in the wall of the sella turcica to expose the pituitary gland. The adenoma can be readily distinguished from the normal pituitary gland tissue and is removed without removing the normal gland. After the surgeon removes all the tumor tissue, the small cavity that is left is treated with alcohol to destroy any tumor cells that may remain. This cavity is then sealed, sometimes with a piece of fat that the surgeon removes from the patient's abdomen. The surgeon then applies a biological 'glue' that helps seal the pituitary area from the nose and promotes natural healing. No nasal packs are used with this approach.