Scarless Endoscopic Endonasal Surgery 

MRI of human brain showing brain tumorEndoscopic endonasal surgery is a type of minimally invasive neurosurgery that accesses the brain through the nasal cavity. Endoscopic tools are used to reach deep within the brain, accessing the base of the skull to treat areas that were previously only accessible using a full craniotomy, which involves opening the skull.

Dr. Peter Nakaji specializes in endoscopic endonasal surgery at Barrow Neurological Institute, serving Phoenix, Scottsdale, and surrounding areas. Dr. Nakaji is a respected leader in minimally invasive brain surgery techniques. Minimally invasive procedures cause less trauma to surrounding healthy tissue, and lead to enhanced healing and recovery time for patients. To learn whether you are a good candidate for this procedure, contact our practice today to schedule a consultation

Endoscopic Endonasal Surgery Applications

Endoscopic endonasal surgery can be used to treat a wide range of diseases and conditions affecting the brain, including:

  • Pituitary Tumors - Growing within the pituitary gland of the brain, this type tumor can be malignant or benign, and causes hormonal imbalances. 
  • Cerebrospinal (CSF) Leaks - CSF leaks occur when the brain's tissue tears and creates a hole. These leaks can cause meningitis, or infection of the brain. Dr. Nakaji diagnoses CSF leaks using computed tomography (CT) scans and magnetic resonance imaging (MRI) before using endoscopic nasal surgery to repair the tear and stop the fluid leak.
  • Craniopharyngioma - This type of brain tumor is derived from the embryonic tissue of the pituitary gland. These slow-growing tumors are usually benign, but must be surgically removed.
  • Juvenile Nasal Angiofibroma - This tumor develops in the back of the nasal cavity and is most often benign. Left untreated, this type of tumor can obstruct the nasal pathways, create facial pain, and eventually invade the eye socket or cranial cavity, causing a variety of neurological issues, as well as blindness.
  • Chondrosarcoma - This abnormal growth occurs in the soft cartilage tissue at the base of the skull.
  • Clival Chordoma - This slow-growing tumor arises from the base of the skull behind the nasal cavity and can grow back towards the brain.
  • Encephalocele - Encephalocele is a defect that causes the brain and other internal tissues to protrude through an abnormal hole in the skull, creating a vulnerable area prone to spinal fluid leaks.
  • Esthesioneuroblastoma - This rare, yet dangerous form of cancer grows within the nasal cavity, and can significantly impact senses including taste, smell, and sight. Dr. Nakaji and his team at the Barrow have experience treating this rare condition. It is one of several sinonasal tumors treated at the Institute.
  • Meningioma - Meningioma grows within the meningal tissue that surrounds the brain, and can be benign or malignant.
  • Orbital tumors - These tumors occur in the socket, or orbit, surrounding the eyeball, which is composed of bone and muscle. Orbital tumors may arise from schwannoma cells.

Treatment for many of these conditions may require additional procedures, medication, or radiation therapy. To determine whether you are a suitable candidate for endoscopic endonasal surgery, Dr. Nakaji and our team will thoroughly evaluate your condition using diagnostic testing, imaging, and endovascular evaluation.

The Procedure: A Closer Look

These procedures often involve Dr. Nakaji working in partnership with an ENT surgeon, skilled in sinus surgery. Patients are fully sedated before undergoing this procedure. First, Dr. Nakaji gently inserts endoscopic tools, including a video camera and light, through the nose up to the base of the skull. Using real-time video feedback, Dr. Nakaji can gather information and deliver ultra-precise treatment. Using highly specialized tools, Dr. Nakaji can safely manipulate, remove, and repair tissues, reducing patients' symptoms and enhancing their overall health.

We recommend our patients stay at least one night at the Barrow Neurological Institute for evaluation after surgery. Patients will receive a prescription to relieve post-surgical pain or swelling, and may have their nose bandaged or packed to help with any residual bleeding. During a follow-up appointment, Dr. Nakaji or the ENT specialist will evaluate the state of the nasal cavity to ensure proper healing.

Learn More

Please contact our office today to learn more about the many benefits of endoscopic endonasal surgery. 

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