PNA Spotlight: Phillip Cem Cezayirli, MD
This month the PNA Spotlight focuses on neurosurgeon Dr. Philip Cem Cezayirli, part of the Haynes Neurosurgical Group in Birmingham, Alabama. Dr. Cezayirli is affiliated with four local medical centers: Princeton Baptist, Shelby Baptist, Grandview, and Brookwood Baptist Medical Centers.
Dr. Philip Cezayirli
He is a board-certified neurosurgeon with a focus on neurosurgical oncology and spine surgery and is licensed to practice neurosurgery in Alabama.
He earned his MD at the University of Alabama at Birmingham School of Medicine in Birmingham, Alabama. He spent a year studying with Dr. Uğur Türe at Yeditepe University and Hospital in Istanbul, Turkey. He did his neurosurgery residency at the Albert Einstein College of Medicine in Montefiore, Bronx New York. And he completed a neurosurgical oncology fellowship at MD Anderson Cancer Center in Houston, TX.
Dr. Cezayiri was kind enough to speak with the PNA about a range of issues. Here is the conversation, edited for clarity.
Expertise needed for tumors that invade the pituitary’s protective layer
The pituitary gland is surrounded by the cavernous sinus and internal carotid artery. A thin layer of connective tissue separates the sinus and artery from the pituitary gland. Pituitary tumors sometimes invade this protective layer, called the medial wall of the cavernous sinus (MWCS).
That infiltration puts pituitary tumors in close proximity to the internal carotid artery and to cranial nerves, significantly complicating treatment approaches — especially when a tumor needs to be entirely removed to achieve cure.
“Standard procedure would be to resect the pituitary tumor up to the medial wall, to avoid damaging the artery. But if there’s tumor in the wall, the patient won’t be cured,” says Mayo Clinic neurosurgeon Dr. Kaisorn L. Chaichana.
MWCS infiltration is more common with functioning adenomas, such as prolactinomas and tumors that cause acromegaly or Cushing’s disease. Incomplete removal of these tumors can lower the chances of hormone control and increase the risk of tumor regrowth.
Fortunately, neurosurgeons are learning how to meet these challenges. Surgically removing part of the MCWS, to completely resect pituitary tumors, can improve outcomes.
“It’s a formidable challenge,” Dr. Chaichana says. “It takes people well-versed in the surgery, and who have experience, to know where they can open that medial wall. If you’re too far to the side — even by less than a millimeter — you would cut the carotid artery, which would be catastrophic.”
Mayo Clinic neurosurgeons use Doppler ultrasound to guide entry into the cavernous sinus, allowing selective resection of the MWCS. “We listen to the sound of the carotid artery, find a space within the medial wall where the artery isn’t present, and make a small slit in that opening,” Dr. Chaichana says. “Then we remove the wall from the carotid artery.”
It’s also important to limit packing of the cavernous sinus after surgery. “Overpacking that site can cause pressure and injury to the cranial nerves, which could lead to facial numbness and eye motion problems,” Dr. Chaichana says.
A multidisciplinary team that includes ENT/head and neck surgeons, as well as neurosurgeons, provides additional anatomical expertise.
“Very few centers do this procedure. But we’ve seen higher rates of remission for functional tumors when we take out that wall,” Dr. Chaichana says. “For a lot of functional tumors, selective resection of the MWCS can mean the difference between tumor remaining and tumor being gone — and therefore, cure or not cure.”
Count on your Xeris CareConnection™ Team for unparalleled Cushing’s Support
Cushing’s can be challenging, but there is support so patients can feel like themselves again. The main goal of treating Cushing’s is to get cortisol levels back to normal. This Pituitary Awareness Month, Xeris Pharmaceuticals® is highlighting the importance of one-on-one support for patients living with Cushing’s Syndrome and support for HCPs treating Cushing’s Syndrome.
Sign up to get dedicated support:
Patients: Sign up for support | Recorlev® (levoketoconazole)
HCP’s: Connect with Xeris support | RECORLEV® (levoketoconazole)
Have more questions? Call for more support at 1-844-444-RCLV (7258)
Copyright © 2024 Pituitary Network Association All rights reserved.
Disclaimer: PNA does not engage in the practice of medicine. It is not a medical authority, nor does it claim to have medical expertise. In all cases, PNA recommends that you consult your own physician regarding any course of treatment or medication.
Our mailing address is:
Pituitary Network Association
P.O. Box 1958
Thousand Oaks, CA 91358
(805) 499-9973 Phone - (805) 480-0633 Fax
Email [email protected]
You are receiving this Newsletter because you have shown interest in receiving information about our activities.
If you do not want to receive any more emails from PNA, Unsubscribe.