Endoscopic Endonasal Surgery
What is endoscopic endonasal surgery?
Endoscopic endonasal surgery is a minimally invasive technique that allows a surgeon
to go through the nose to operate on areas at the base of the brain and the top of
A thin tube called an endoscope is thread through your nostril, nose, and sinuses.
This gives your surgeon access to parts of your brain that would be hard to reach
using traditional surgical approaches that often require large incisions and removal
of parts of the skull.
Why might I need endoscopic endonasal surgery?
Endoscopic endonasal surgery can be used to remove tumors in areas near the base of
the brain or skull, and at the top of the spine. It can also be used to treat problems
with the sinuses. This approach allows the surgeon to reach these areas without the
need for large incisions or removal of parts of the skull. This often makes recovery
quicker and less painful.
What are the risks of endoscopic endonasal surgery?
Any major surgery carries some risk. Most people get through this surgery and heal
without problems. But complications can develop. Possible risks include:
Reactions to the anesthesia
Hematoma (a pooling of blood in the wound site)
Damage to veins, arteries (carotids), nerves (especially those that control vision
and eye movements), and other structures in the area
Cerebrospinal fluid (CSF) leaking from the nose
Infection including meningitis
The procedure may carry other risks, depending on your specific health condition.
Talk about any concerns with your surgeon before the procedure.
How do I get ready for endoscopic endonasal surgery?
You will be under general anesthesia for this surgery. That means you will be asleep
and won't feel anything. If you have any questions about the anesthesia or about any
other aspect of the procedure, be sure to ask your medical team in advance.
You can increase the chances for success by preparing correctly. In general, presurgery
preparation involves these steps:
If you smoke, quit at least 2 weeks before your surgery. This will make anesthesia
more successful and help with healing.
Don't take over-the-counter pain relievers for 2 weeks before your surgery. This includes
common products like aspirin and ibuprofen.
Don't take vitamin E for 2 weeks before the surgery.
Make sure to tell your healthcare provider about any medicines you are taking, any
other health problems you have, and any problems you've had with previous operations
Follow any directions you are given for not eating or drinking before surgery.
You should arrive for surgery at least 2 hours before your procedure or as instructed
by the surgery center. Check in at the admissions desk to fill out any necessary forms,
including a consent form that must be signed before the surgery can begin.
Your surgical team will give you more specific directions to follow before the procedure. Some
of these might be slightly different from those listed above.
What happens during endoscopic endonasal surgery?
You will be asked to change out of your clothes and into a gown. A nurse will start
an intravenous (IV) through which you will get fluids and medicine during the procedure.
You might be given a sedative to help you relax. After you have spoken with the anesthesiologist
and your surgeon, you will be given the anesthesia that will let you sleep through
During the procedure, your surgical team will thread a thin tube through your nose
and sinuses to shine a light and a camera on the spot where they need to operate.
The camera relays images to a monitor in the operating room during the surgery. Specially
designed tools will also be inserted through the nose to drill bone, stop any bleeding,
cut out and remove tumors or other problem areas.
Some steps might be slightly different from those outlined above. Talk with your healthcare
team about what might happen during your procedure.
What happens after endoscopic endonasal surgery?
After your operation, your nose and sinuses may be packed with bandages. These are
usually removed within a week after the surgery. You also will be given antibiotics
to fight infection. If you feel pain or discomfort, let your healthcare providers
know. Most people spend 1 to 2 days in the hospital before going home.
Once you are discharged, take any prescriptions you are given as instructed and follow
all postoperative instructions.
Call your healthcare provider right away if you are confused about how to take the
recommended medicines. Get medical care right away if any of the following occur:
Pain and headaches that can't be managed with prescribed medicines
Fever of 100.4˚F (38˚C), or higher, or as advised by your provider
Redness, tenderness, heat, or pus, which are signs of infection, at the surgery site
Swelling in the area around the nose
Shortness of breath or trouble breathing
Any clear and salty tasting drainage from the nose, especially when sitting or standing
Your healthcare team may give you other instructions about what you should do after
Before you agree to the test or the procedure make sure you know:
The name of the test or procedure
The reason you are having the test or procedure
What results to expect and what they mean
The risks and benefits of the test or procedure
What the possible side effects or complications are
When and where you are to have the test or procedure
Who will do the test or procedure and what that person’s qualifications are
What would happen if you did not have the test or procedure
Any alternative tests or procedures to think about
When and how you will get the results
Who to call after the test or procedure if you have questions or problems
How much you will have to pay for the test or procedure