The temporomandibular joint (TMJ) is a small joint located in front of the ear where the skull and lower jaw meet.

It permits the lower jaw (mandible) to move and function.

Therefore, we all have 2 TMJ‘s, however when the joints are causing discomfort, TMD may be the cause.


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    Transphenoidal Approach For Pituitary Tumors

    Dr. Gregory Casey is highly trained in Pituitary Tumor Surgery and has worked for over a decade with neurosurgeon Dr. Eric Eskioglu out of Physicians hospital in Naples helping improve lives of patients from all over the country. We offer a package that offers exam, surgery and hotel accommodations prior to surgery for out of town patients. Please contact us for a consult.

    The patient’s symptoms and results of physical, eye and neurological exams may lead physicians to suspect a pituitary tumor. To confirm the diagnosis, your doctor may recommend a magnetic resonance imaging (MRI) scan and other tests to check for excess hormones.

    About Pituitary Tumors

    Pituitary tumors are abnormal growths that develop on the pituitary gland in the brain and are almost always noncancerous (benign). The majority of pituitary tumors (adenomas) do not spread outside the skull (nonmetastatic) and usually remain confined to the pituitary gland or nearby brain tissues. Pituitary tumors are fairly common and are often coincidentally diagnosed during an MRI scan performed for another reason.
    Although a pituitary tumor does not grow and spread extensively, it can have a big impact on health. Tumors in this part of the skull have limited room to grow. Thus, pituitary tumors can exert pressure and cause damage to nearby parts of the brain, such as the nerves leading to the eyes.
    Some pituitary tumors also can press on and damage the remaining pituitary tissue, causing a reduction of pituitary hormones, a potentially serious problem. Other tumors produce too much of one or more pituitary hormones, which can cause serious health problems in other organs.


    Treatment for pituitary tumors depends on the tumor type and size, its proximity to the eye nerves, and the patient’s age and overall health. Most pituitary tumors are noncancerous. Nonfunctioning pituitary tumors do not produce hormones; functioning pituitary tumors cause overproduction of hormones.
    Observation,surgery and medications are the main treatments for pituitary tumors. Surgical & technological advances have allowed surgeons now to perform an endoscopic through-the-nose surgical technique that is highly successful when the tumor is small. Most smaller, nonfunctioning tumors are carefully monitored and observed over time and do not require surgical treatment.
    Dr. Gregory Casey is highly trained in the sublabial approach
    Dr. Casey uses the sublabial approach and utilizes the state-of-art Brain Lab navigation technology. The sublabial approach for pituitary surgery goes through the upper lip to open a path between the hard palate in the roof of the mouth and the nose.  Although there are several approaches to the sphenoid sinus, the sublabial transseptal and transnasal transseptal approaches are presently the most widely accepted standard techniques. 
    Although the transnasal approach has several advantages in comparison with the sublabial approach, it is difficult to accomplish in the small nostril without an alotomy incision or external rhinoplasty incision, which may lead to noticeable scarring or nasal deformity. 
    Therefore, the sublabial approach [which is less invasive] still remains the optimal method, especially for patients with small nostrils.

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      Dr. Casey and his team helped my husband thru a difficult time. My husband was petrified of surgery and neglected his teeth. Dr. Casey and his team crated a treatment plan that was affordable. My husband was put to sleep and had extractions of 10 teeth and 10 implants and bone grafts done the same day. I can't rave enough.. he had tenderness and mild discomfort for about 3 days and then totally fine! So glad we found Blue Wave surgery and Dr. Casey.
      Samantha Peters

      Encompassing All Accessible Exclusive Oral Surgery Treatment

      We offer extensive Oral and Maxillofacial procedures in a JCAHO accredited facility