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X ray of the skull base 
EEA Clinical Case Study

Learn how UPMC neurosurgeons have used the Endoscopic Endonasal Approach (EEA) to remove difficult tumors and lesions from the skull base — through the nose.

Read full case studies »


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Endoscopic Endonasal Approach for Brain Surgery (EEA)

Celebrating 25 Years

For more than 25 years, UPMC surgeons have been pioneering treatments and technology to access and remove tumors at the base of the skull, including the Endoscopic Endonasal Approach (EEA).

Because the base of the skull has proven to be one of the most challenging regions of the body to access, treatment options were once limited for patients with tumors or lesions in this area. However, with recent advancements and breakthroughs in treatment and surgery, patients with skull base tumors now have an array of surgical options that can help them return to leading a normal and active life.

How EEA for Brain Surgery Works

The Endoscopic Endonasal Approach is an innovative surgical technique used to remove brain tumors and lesions—some as large as softballs—all through the nose. Our multidisciplinary team of neurosurgeons, otolaryngologists, ophthalmic surgeons, and spine surgeons have developed and refined this technique, and are among the most experienced in the world.

With EEA:

  • Surgeons reach tumors and lesions of the skull base and top of the spine directly by operating through the nose and sinuses.
  • A specially designed endoscope provides light and a lens for viewing and transmitting internal images.
  • Highly crafted instruments are used alongside the endoscope for dissection and tumor removal.

At UPMC, these surgeries are performed in dedicated, state-of-the-art suites that incorporate sophisticated imaging technology.

What EEA Treats

This minimally invasive approach uses the nose and sinuses as natural corridors to access tumors and lesions in critical areas at the base of the skull or top of the spine. The Endoscopic Endonasal Approach allows surgeons to treat many hard-to-reach tumors, even those once considered "inoperable," without disturbing the face or skull.

» Learn about the conditions treated with EEA

The Many Benefits of EEA Surgery

EEA offers patients a number of benefits that may improve their quality of life, including: no facial incisions or disfigurement, less trauma to the brain and critical nerves, fewer side effects, and shorter recovery times.

» Read more about EEA's benefits 

EEA Patient Successes

UPMC surgeons have treated more than 2,000 patients using the Endoscopic Endonasal Approach, and were the first in the world to perform a number of procedures using this technique. Their vast experience with EEA allows UPMC's surgical team to constantly refine their skills and to expand the possible uses for this innovative approach.

In addition to its successful use in adults, EEA has proven safe and effective in children. More than 100 children have been treated by UPMC surgeons using the Endoscopic Endonasal Approach—more than at any other neurosurgery center in the world.

» Read some of our EEA patient success stories
» Read clinical case studies 
» Read common FAQs
» Read about EEA breakthroughs

Skull Base Surgery Teaching and Research

As part of the University of Pittsburgh School of Medicine, the Department of Neurosurgery is committed to academic and research excellence, in addition to clinical excellence.

» Learn more about our education, research, and training opportunities

Meet Elsa

Elsa Arce – Meningioma , Optic Nerve Compression

When Elsa was diagnosed with a large meningioma, the experts at UPMC recommended EEA surgery.

Read more »



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