The thought of a brain tumor diagnosis is understandably frightening, but through decades of research by skilled practitioners, we’ve determined a treatment that is less invasive for the removal of these tumors. This will help give you back your peace of mind in what is no doubt a terrifying time. Read on to learn more about this approach!
The skull base is the border between the brain and the nose and sinuses. Rhinologists have expertise in this area, often with neurosurgery colleagues, treating tumors within the nose or within the brain.
- Past and Present
Traditionally, these tumors were approached through cuts in the scalp, head, face, nose, and inside the mouth. This leads to obvious scars and was associated with longer recovery times and hospital stays. However, many of these tumors can now be treated using minimally invasive approaches through the nose. This is termed the endoscopic endonasal approach to the skull base or endoscopic skull base surgery (EEA).
As medicine has evolved over the years, this type of expertise is becoming more widespread. These surgeries are often performed using a team, meaning the expertise of both rhinologists and neurosurgeons join together to provide the best care for each patient.
- What can be treated via EEA?
The earliest indications for EEA were for pituitary tumors, and they remain the most common disease treated using this approach. Over time, through research and experience, EEA is now being used as a treatment for tumors both originating from within the nose or tumors completely within the brain. Some centers with experience and expertise can even tackle tumors in risky areas, such as the brainstem or those invading the brain, with overall successful outcomes.
The steps of EEA are broken down into the following:
- The approach, where a passageway through the nose and sinuses to the skull base is created.
- The resection, where a two-teamed approach to tumor removal is taken on in a highly cautious manner.
- The repair or reconstruction, where the hole between the brain and nose and sinuses is closed up.
- Advantages and Disadvantages of EEA
The minimally invasive nature of EEA allows patients to have shortened recovery time without external incisions. The team approach allows for two surgeons to be actively involved. One provides a clear, optimal view of the tumor while the other can work with both hands around delicate places. The rhinologist knows how to take care of the sinuses after surgery, while the neurosurgeon works on safe and effective tumor treatment.
However, EEA shifts the burden of recovery of the patient to the technical demands of the surgical team. As it generally takes longer to recover from EEA than from traditional surgery. The nose takes time to heal after surgery, and special attention is given to the repaired hole in the skull base. The surgical team will discuss this with the patient based on the extent of the surgery.
…Okay, it is actually brain surgery
While it is minimally invasive, EEA is just another way of getting to where the tumor is and does not change how it is treated. The best outcomes are achieved by an experienced surgical team working with the patient, with many centers adopting comprehensive programs to facilitate this relationship.