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Blue banner with an image of a clear head that you can see the brain through with a small probe entering through the nose with text that says, " EEA is a minimally invasive technique pioneered and refined at UPMC that gives neurosurgeons access to the base of the skull, central brain, and top of the spine by operating through the nose and sinuses.”

Endoscopic Endonasal Approach for Brain Surgery (EEA)

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Marking More Than 5,000 Procedures

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

The UPMC Center for Cranial Base Surgery performed its 5,000th EEA procedure in 2025. It was the first in the world to perform a number of procedures using this technique, and it is one of the busiest centers in the world for endoscopic treatment of pituitary tumors and tumors of the cranial base. 

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

An NASBS Multidisciplinary Team of Distinction

Multidisciplinary Team of Distinction.

The Multidisciplinary Team of Distinction designation is based on meeting North American Skull Base Society (NASBS) membership criteria and may not be construed as a Medical Referral.