Skull base
Endoscopic endonasal approach
Also called: EEA, endoscopic transsphenoidal surgery
The endoscopic endonasal approach reaches the skull base through the nose and sphenoid sinus using an endoscope, avoiding brain retraction but carrying a risk of CSF leak.
In the endoscopic endonasal approach (EEA), surgeons pass an endoscope and instruments through the nostrils and sphenoid sinus to reach the pituitary fossa and the midline skull base. It is the standard route for most pituitary adenomas and is widely used for craniopharyngiomas and selected tuberculum sellae meningiomas.
Its main advantages are a direct midline view of the tumor and the optic apparatus from below, with no brain retraction. Its main risk is a postoperative cerebrospinal fluid (CSF) leak, which can lead to meningitis; vascularized nasoseptal flaps have greatly reduced this risk.
Transcranial approaches remain preferred for tumors with wide lateral extension or arterial encasement, so many decisions are framed as endoscopic versus open.
Tools that use this
- Craniopharyngioma Outcomes StudioPredict tumor recurrence and permanent diabetes insipidus after craniopharyngioma surgery, with SHAP explanations and an extent-of-resection trade-off.
- Tuberculum Sella Meningioma StudioCompare endoscopic and transcranial plans for tuberculum sellae meningioma, from partial to gross-total resection, and predict post-op visual improvement.
Related terms
Educational reference. Not medical advice and not for clinical decision-making.