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Expanded Endonasal Surgery

The Expanded Endonasal Approach (EEA) is an innovative type of minimally invasive brain surgery that allows surgeon to access the skull base and upper cervical spine to remove brain tumors and other lesions through nose and sinuses. It is a standard of care for accessing a wide variety of hard-to-reach tumors and other skull base lesions (as large as softballs) without disturbing the face or skull.

expanded endonasal approach

Indications for EEA

The Expanded Endonasal Approach can be performed in following brain and spine conditions:

  • Brain tumors like:

  • Cancers of the sinus like

    • Squamous cell

    • Sphenoid sinus carcinomas

    • Adenocystic

  • Meningiomas of the skull base 

  • Pituitary tumors like

    • Pituitary adenomas

    • Acromegaly

    • Prolactinoma

    • Pituitary apoplexy

  • Olfactory neuroblastomas

  • Rathke’s cleft cysts

  • Skull base tumors and cysts

  • Chordoma and chondrosarcomas

  • Orbital tumors and Graves’ disease

MEEA Procedure

The approach uses the nose and sinuses as natural corridors to access tumors and lesions in critical areas at the base of the skull or top of the spine (cervical). The procedure is performed using a specially designed endoscope that provides light and a lens for viewing and transmitting internal images. The surgeon enters the skull base through nose. The tumor is removed using highly crafted instruments, high-definition optics and an endoscope. Finally, the skull base is reconstructed to seal off the brain from the nose.

Benefits of EEA

  • Skull base tumors can be accessed without the complications of open skull base surgery

  • Detailed, high-resolution view of the operating field

  • Neurosurgeon can perform precise movements using the microsurgical instrument

  • No need of face incisions and brain retraction

  • No visible scar

  • Fewer side effects

  • Less hospitalization (only 1 to 2 days)

  • Shorter recovery time

  • Less pain during and after surgery

  • Less disruption of critical nerves

  • Decreased morbidity


Authored By Dr. Manish Vaish

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