Expanded endoscopic endonasal surgery approach

Revolutionizing the way brain surgeons access the skull base and upper cervical spine – so you can recover faster.

Technique

During endoscopic endonasal surgery, a neurosurgeon and an otolaryngologist – a head and neck surgeon – work together to enter the skull base through the nose. This minimally invasive technique eliminates the need for external incisions and brain retraction.

By removing the back half of the nasal septum (the divider between the two sides of the nose) and the bone in front of the sphenoid sinus (the farthest back of the paranasal sinuses), surgeons can reach the skull base.

Tumors are then removed with the help of high-definition optics and an endoscope. Finally, the skull base is reconstructed using a flap of the septal membrane – which seals off the brain from the nose – helping prevent complications

Benefits

The expanded endonasal approach (EEA) allows access to skull base tumors without the complications often seen with open skull base surgery. These complications include infections associated with large scalp incisions and the side effects seen with brain retraction.

Most patients undergoing the expanded endonasal approach spend only one to two days in the hospital. Recovery time at home is much shorter than for open skull base surgery. In addition, there are many scenarios in which the expanded endonasal approach causes less disruption of critical nerves during skull base surgery.

Before this innovative approach was developed, removing skull base tumors required a craniotomy (partial removal of the skull) and drawing back brain tissue. There are still cases in which this approach may be necessary, but for the majority of lesions in the skull base and cervical spine, the expanded endonasal approach can be performed.

Conditions we treat

The expanded endonasal approach is used to perform minimally invasive brain surgery and minimally invasive spine surgery for these conditions:

• Brain tumors
• Cancers of the sinus
• Meningiomas of the skull base
• Pituitary tumors (including pituitary adenomas, acromegaly, prolactinomas, pituitary apoplexy)
• Olfactory neuroblastomas
• Rathke’s cleft cysts
• Skull base tumors and cysts
• Chordomas and chondrosarcomas
• Orbital tumors and Graves' disease