Transnasal Endoscopic Surgery
The Department of Neurosurgery at Mount Sinai offers innovative, advanced surgical treatment options for the management of brain tumors and lesions in the skull, including transnasal endoscopic surgery.
By going through the nostrils, a surgeon can access skull tumors and lesions – both large and small – that were once hard to reach, such as meningiomas, pituitary tumors, and various types of suprasellar tumors and carcinomas.
This minimally invasive approach offers patients a new option to remove tumors without having to undergo traditional surgery, which can be more invasive and can prolong recovery times.
How does Transnasal Endoscopic Surgery Work?
At Mount Sinai, a multidisciplinary team of neurosurgeons and ear, nose, and throat surgeons work together to remove these skull base tumors through the nose in state-of-the-art operating suites. The surgeons enter the frontal base of the skull through one or both nostrils using a tiny instrument called an endoscope, a long flexible tube with a light and video camera.
The soft tissues are removed and a small portion of the bone is drilled off with a diamond tip drill. The dura mater, a thick membrane on the outmost layer of the meninges that surround the brain and spinal cord, is exposed. The dura is then opened and the associated tumor is dissected from the brain structure. From there, the surgical team repairs any soft tissues impacted during the minimally invasive surgery.
“The technique requires a team of skilled surgeons, which we offer at Mount Sinai. Even with a skilled team, the procedure can take between four to six hours because the access area through the nose is very small,” said Joshua Bederson, MD, Chair and Professor of Neurosurgery at Mount Sinai.
Benefits of Transnasal Endoscopic Surgery
More than 100 neurosurgery patients a year elect this minimally invasive approach at Mount Sinai. This is because it offers several benefits compared to traditional skull base surgeries, including:
- Decreased risk of neurological damage
- Less trauma to surrounding nerves
- No incisions or scars
- No facial or skull disfigurement
Additionally, the minimally invasive nature of the technique allows patients to recovery quicker so they can return to their normal routine.
“The recovery is very fast and patients are usually discharged within one to two days with a nasal pack to reduced swelling,” said Dr. Bederson.
Some patients might experience minor pain, often relieved by over the counter pain medications. Side effects of the surgery are very few and might include nasal discharge or crusting.
A neurosurgeon would provide specific post-operative instructions during a treatment consultation.
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