Athens-Clarke Endoscopic Endonasal Surgery

Identifying the area inside your skull that requires surgery is just one step required in order to treat your neurological condition. The more challenging step is accessing that area. Fortunately, you might be a candidate for a procedure called endoscopic endonasal surgery. This surgery uses an endoscope — a rigid tube with a camera and light on one end — that accesses the inside of your body by being fed through your nose and sinuses, which are small cavities in the skull around the area of your nose.

The main advantage of endoscopic endonasal surgery is that it’s considered minimally invasive. Compared to traditional “open” procedures, minimally invasive surgery often:

  • Requires fewer incisions (cuts) to your face and skull during the surgery
  • Needs less time to recover, and with less pain afterward
  • Minimizes trauma to surrounding nerves and parts of the brain, which causes complications or the need for facial reconstruction

Reasons for Endoscopic Endonasal Surgery

Endoscopic endonasal surgery is a treatment chosen for tumors near the brain, skull base, spine, and pituitary gland, many of which are hard to reach. These conditions include:

  • Craniopharyngiomas — benign (meaning they don’t spread, like cancerous tumors) brain tumors that usually form near the pituitary gland and a part of the brain called the hypothalamus
  • Chordomas — a bone cancer that appears in the bones of the bottom (base) of the skull or spine
  • Cushing’s disease — when a tumor causes the pituitary gland to create too much cortisol, resulting in symptoms that include a fatty hump on the back of your neck, a rounded face, and purple stretch marks around the breasts, arms, thighs, and stomach
  • Meningiomas — slow-growing tumors appearing in the membranes surrounding the brain and spinal cord (the meninges) 

Preparing for Endoscopic Endonasal Surgery

Preparing for endoscopic endonasal surgery is similar to preparing for other kinds of surgery requiring general anesthesia, which means you will be asleep and won’t feel anything during the procedure.

Your surgeon will give you instructions tailored to your condition and personal factors including age, weight, and medical history, but your preparation will likely include:

  • Quitting smoking (if you smoke) for at least two weeks before the procedure to improve recovery
  • Not taking certain medications and supplements that can increase bleeding — such as aspirin, ibuprofen, and vitamin E — two weeks before surgery
  • Informing your surgeon about anything that might impact the procedure  
  • Following instructions regarding when to stop eating or drinking before surgery

What Happens during Endoscopic Endonasal Surgery

The specifics of the procedure will depend on what you’re being treated for, but in most cases, the surgical team will send the endoscope through your nose and sinuses toward the location where the operation will take place. The light and camera on the end of the tube will inform the team as they operate. Through this same tube, special tools will be inserted to perform the procedure, which could include drilling through bone, removing a tumor, and stopping any bleeding.

The procedure often takes two hours, but if your case is more complicated, it could take up to six hours. After you wake up from the anesthesia, you’ll likely spend from two to five days in the hospital, based on your vital signs, such as how well you’re breathing and your blood pressure, body temperature, and heart rate.

Following your surgery, your nose and sinuses may be packed with bandages (which are usually removed within a week) to prevent leakage. You may feel nausea, headaches, a stuffy nose, or other kinds of soreness in the area after surgery. This is normal, but your recovery team will check to make sure you’re not suffering from any complications. 

When You Return Home

You will receive detailed instructions on how to recover once you return home. You’ll likely receive medications, including antibiotics, so make sure you or someone you know can pick up your prescriptions. You’ll also have follow-up appointments that will check on your progress.

Before you fully return to normal activities, you’ll be required to follow certain precautions related to:

  • Driving
  • Bathing
  • Taking care of your nasal area
  • Returning to work
  • Any warning signs or symptoms that require you to contact your doctor or go to the emergency room 


Although endoscopic endonasal surgery is considered safe — and, as a minimally invasive procedure, has several advantages over traditional surgery — every major surgery comes with risks. Because the procedure takes place in your nasal area, you may temporarily lose your sense of smell. Your surgeon will discuss other risks related to your particular condition.

Make an Appointment with Dr. Woodall Today

Endoscopic endonasal surgery requires skill, experience, and precision. Dr. Woodall has the training and experience to provide the comprehensive, patient-centered care you can trust. Contact our office today.