The neurosurgeons of the Department of Neurosurgery work closely with the Cedars-Sinai Pituitary Center, which integrates medical, surgical, research, imaging and pathology components -- all in one centralized location. It is one of the first centers in the United States where endocrinologists and surgeons work side by side to provide patients with the full spectrum of care for pituitary disorders -- from initial triage and complete diagnostic services through surgical intervention and post-operative follow-up.
The Pituitary Center houses the full spectrum of diagnostic, medical and surgical services. The Center is unique in that it integrates two specialties -- neuroendocrinology and neurosurgery -- allowing physicians to take a holistic approach to diagnosing and treating pituitary tumors and other disorders.
Services include neuroendocrinology, neurosurgery, an Endocrine Diagnostic Testing Unit, neuroradiology, including MRI and SPECT imaging, radiotherapy, neuro-opthalmology, neuropathology, and patient support groups.
The Center is under the direction of Dr. Shlomo Melmed, a world-renowned endocrinologist and researcher. Widely considered one of the pre-eminent experts on the pituitary, Dr. Melmed has authored or co-authored hundreds of articles on the topic. He also serves as Editor-in-Chief of The Pituitary Journal and writes the premiere classic text, The Pituitary. He serves as Director of the Cedars-Sinai Research Institute and as Senior Vice President of the Medical Center's Academic Affairs Department. Dr. Vivien Bonert, the Center's Medical Coordinator, enjoys national repute as an expert in diagnosing and treating pituitary disorders.
Because Cedars-Sinai is one of the nation's leading facilities in pituitary disease research and treatment, the Pituitary Center offers the most advanced treatment options, including novel therapies for pituitary tumors, growth hormone replacement for adults and pituitary function testing. In addition, because Cedars-Sinai oversees more pituitary disease clinical trials than almost any other facility in the country, patients have unparalleled access to these research protocols. The Center has several large NIH grants in pituitary disease and research, as well as an NIH training grant.
Pituitary Center patients also have direct access to leading-edge skull base surgery techniques and technology, including endoscopic techniques to remove pituitary tumors. Since the Department of Neurosurgery is closely associated with the Pituitary Center, patients receive the full continuum of care, from medical treatment to surgical expertise when necessary. Due to the multidisciplinary nature of the Pituitary Center, patient care is highly individualized.
One important advance is the minimally invasive, endoscopic approach to treating pituitary tumors and other neurosurgical disorders. This innovative procedure utilizes a tiny endoscope - 2.7 mm wide and 20 cm long - with angled tips that is inserted through the nostril and into the pituitary sella. This approach offers many advantages in terms of the surgery and recovery period.
First, since the camera is at the tip of the endoscope, surgeons have a vivid panoramic view of the brain. They can look around corners and improve visual assessment. Since the point of entry is through a nostril, no incision is required. Consequently, there is no scarring or nasal packing, and the brain is undisturbed. The time required for the actual surgical procedure, the length of hospital stay and overall recovery time are dramatically reduced. Patients return home within 24 to 48 hours of surgery and, in most cases, enjoy a rapid overall recovery and return to work and normal activities.
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