Endoscopic Endonasal Surgery

Endoscopic endonasal surgery is a minimally invasive technique that allows a surgeon to go through the nose to correct problems or remove a tumor in various areas of the brain and the top of the spine.

About the procedure

A thin tube called an endoscope is threaded through your nose and sinuses, giving your surgeon access to parts of your brain that would be difficult to reach using traditional surgical approaches. Those techniques are more complicated and require large incisions and removal of parts of the skull. With the endoscopic endonasal approach, your recovery is often quicker and less painful.

Illustration of the sinuses


Any major surgery carries some risk. Most people get through this surgery and heal without problems, but complications can develop. Possible risks include:

  • Excessive bleeding

  • Hematoma (a pooling of blood in the wound site)

  • Damage to veins, arteries, nerves, and other structures in the area

  • Scarring

  • Infection

  • Slow healing

  • Blood clots

  • Pneumonia

The procedure may carry other risks, depending on your specific medical condition. Be sure to discuss any concerns with your surgeon before the procedure.

Before 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 pre-surgery preparation involves these steps:

  • If you smoke, quit at least two weeks before your surgery. This will make anesthesia more successful and help with healing.

  • Don't take over-the-counter pain relievers for two weeks before your surgery. This includes common products like aspirin and ibuprofen.

  • Don't take vitamin E for two weeks before the surgery.

  • Make sure to tell your doctors about any medications you are taking, any other health problems you have, and any problems you've had with previous operations.

  • Don't eat and drink anything for about eight hours before your surgery.

  • You should arrive for surgery at least one hour 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 for you to follow in advance of the procedure. 

The surgery

You will be asked to change out of your clothes and into a gown. A nurse will start an IV through which you will get fluids and medication 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 the operation.

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 cut out and remove out the tumor.

After 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 doctors and nurses know. Most people spend a day or two 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 doctor if you are confused about how to take the recommended medications or if any of the following occur:

  • Pain that can't be managed with prescribed medications

  • Fever of more than 100 degrees

  • Shaking chills

  • Redness, tenderness, heat, or pus, which are signs of infection, at the surgery site

  • Swelling in the areas near the incision

  • Shortness of breath or difficulty breathing

  • Chest pain

  • Any clear drainage from the nose