The Expanded Endonasal Approach (EEA):
This approach uses the nose as a natural corridor to base of the skull and brain. Using this approach provides direct access to the tumor without the need for external incisions. The EEA is indicated when the critical structures surround the tumor along its’ perimeter. The principle is that the tumor (target) is encountered first without manipulating or moving any of the important surrounding nerves and brain tissue. It is like eating the apple from the core outwards leaving the structures attached to the skin intact – “Inside out surgery”. Therefore, there is minimal manipulation of the critical structures, thus allowing for the potential for reduced morbidity, less discomfort and disfiguration for the patient and quicker recovery. The procedure in correctly selected individuals and performed by surgeons with adequate experience, can reach from the bridge of the nose to the upper part of the spine.
The endonasal approach is the preferred route for virtually all pituitary adenomas, Rathke’s cleft cysts, as well as many midline meningiomas, craniopharyngiomas, chordomas, olfactory neuroblastomas and other lesions. It is also used for performing odontoid resection in patients with rheumatoid arthritis.
Dr. Kassam and Kelly are internationally regarded as pioneers of this procedure representing an experience of over 2,000 cases collectively. They have helped define the anatomy and instrumentation needed and have taught this approach at both national and international courses and symposia.
Choose from the following approaches to learn more:
