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Neurosurgeon Dr. Amin Kassam and the team at Endeavor Health Neurosciences Institute’s Advanced Neurosciences Center are pioneers of endonasal skull base surgery—surgery on the inside of the skull that is performed through the nasal cavity. Accessing tumors of the skull base was once considered prohibitively risky, as it involved highly invasive procedures. But these cases are now standard practice for our dedicated team of experts. With this approach to surgery, a patient’s time in the hospital and side effects are reduced, as endonasal surgery recovery time is much shorter than with alternative techniques.

What is endonasal skull base surgery?

Endonasal skull base surgery is a minimally invasive surgical procedure during which a neurosurgeon accesses the inside of a patient’s skull base through the nostrils. The natural access point of the nose eliminates the need to cut into the skull to perform surgery, drastically reducing the risks and side effects of tumor removal.

During the surgery, a small camera (an endoscope) is inserted into the nasal cavity, allowing the neurosurgeon to navigate the way and magnify the area of concern. The tools used to remove the tumor and tissue are also inserted through the nasal cavity. 

A woman stands watch in neurosurgery

Which diagnoses are candidates for endonasal skull base surgery?

There was a time when skull base tumors or other skull base conditions came with a poor prognosis, due to the presence of vital structures, including the eyes, nerves, major blood vessels, and the pituitary gland, around the operation site. Today, innovative techniques in endonasal skull base surgery have changed that.

At the Advanced Neurosciences Center, our team has led the way in performing this procedure and creating a life-changing option for many patients. Some of our patients who had once been told they had inoperable tumors not only had successful outcomes, but they have walked out of our practice within days of surgery.

We can treat several conditions with this procedure, including, but not limited to:

What are the side effects of endonasal skull base surgery?

Endonasal surgery side effects are far fewer and less severe than those of other, more invasive skull base surgeries. In some instances, complications can be reduced significantly. However, as with any surgery, there are risk factors to consider and side effects to be aware of. These include:

  • Reactions to anesthesia
  • Bleeding
  • Blot clots
  • Cerebrospinal fluid leak from the nose
  • Infection

You can increase your chances of a successful surgery by taking some precautions before surgery, including:

  • Stop smoking at least two weeks in advance of surgery
  • Cease over-the-counter medication use for two weeks before surgery
  • Speak to your team regarding prescription medications so they can check for interactions
  • Review all pre-operative instructions, and ask questions of your care team

What happens after endonasal skull base surgery?

Patients who proceed with this procedure report less discomfort and healing time than with other surgical techniques. Pain management can often be handled with over-the-counter medication.

Endonasal surgery recovery involves bandages packed into the nose at the entrance point. Typically, the bandages are removed within a few days. You will also receive antibiotics to prevent infection. You can expect to remain with your care team for monitoring for a couple of days. Follow-up care is essential with any procedure.

At the Advanced Neurosciences Center, our team supports you from diagnosis through recovery and beyond. You are always the most important member of the team, and you deserve the care of specialists who are leading experts in your diagnosis.

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