Endoscopic endonasal surgery

A surgical technique for accessing the skull base and brain through the nasal passages

Endoscopic endonasal surgery (EES) is a minimally invasive surgical technique that allows surgeons to access the skull base and certain regions of the brain through the nasal passages. This approach utilizes an endoscope, a thin, flexible tube equipped with a camera and light, to provide visualization of the surgical area.

Overview

Endoscopic endonasal surgery is primarily used to treat conditions affecting the skull base, sinuses, and certain brain regions. It is a preferred method for removing pituitary tumors, repairing cerebrospinal fluid leaks, and addressing other abnormalities located at the base of the skull.

Procedure

The procedure involves inserting an endoscope through the nostrils to reach the target area. The endoscope provides a magnified view of the surgical field, allowing the surgeon to operate with precision. Specialized instruments are used alongside the endoscope to perform the surgery.

Steps

1. Anesthesia: The patient is placed under general anesthesia. 2. Endoscope Insertion: The endoscope is carefully inserted through the nasal cavity. 3. Navigation: Surgeons use image guidance systems to navigate to the surgical site. 4. Surgical Intervention: Using endoscopic tools, the surgeon performs the necessary intervention, such as tumor removal or leak repair. 5. Closure: The surgical site is closed, often using tissue grafts to ensure proper healing.

Advantages

Endoscopic endonasal surgery offers several advantages over traditional open surgery:

• Minimally Invasive: Reduced trauma to surrounding tissues and faster recovery times.
• No External Incisions: The procedure is performed entirely through the nostrils, leaving no visible scars.
• Improved Visualization: The endoscope provides enhanced visualization of the surgical area.

Applications

EES is used to treat a variety of conditions, including:

• Pituitary adenomas
• Craniopharyngiomas
• Meningiomas
• Chordomas
• Cerebrospinal fluid leaks

Risks and Complications

While EES is generally safe, it carries potential risks and complications, such as:

• Infection
• Bleeding
• Cerebrospinal fluid leak
• Vision problems

Postoperative Care

After surgery, patients may experience nasal congestion and mild discomfort. Follow-up care includes:

• Regular check-ups to monitor healing
• Nasal irrigation to keep the nasal passages clear
• Avoidance of strenuous activities for a specified period

Related pages

• Endoscopy
• Minimally invasive surgery
• Skull base surgery
• Pituitary gland

Endoscopic_endonasal_surgery

• Endoscope used for endonasal surgery
  Endoscope used for endonasal surgery
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  Illustration of nasal cavities