Endoscopic Endonasal Approach Surgery for Pituitary Tumors

This animation illustrates the removal of a large tumor near the pituitary gland using the Endoscopic Endonasal Approach or EEA. The entire procedure is performed through the nose and sinuses, without incisions to the face or skull.

First, the endoscope is inserted through the nose and sinuses to directly reach the tumor, without manipulating the brain or important nerves. The tumor and surrounding area are brightly lit by the endoscope, which has a tiny camera that sends real-time video images to a large screen. Specially designed surgical tools are inserted next to the endoscope to cut through the tumor capsule.

In this example, bits of tumor are removed with suction and micro-scissors, until the entire tumor is gone. Throughout the procedure, the surgeons have an excellent view of surrounding tissue, helping them to preserve important nerves and arteries that control vision and other functions. Because the brain is not disturbed, the recovery time after EEA surgery is typically days, instead of weeks or months.

At UPMC, EEA surgery may be used for a wide array of tumors and lesions in the skull base and upper spine, both benign and malignant. Since there are no incisions to heal, complementary treatments, such as radiation therapy or chemotherapy, may be started soon after EEA surgery, if needed.

Surgery is complete, and the patient has no visible scars on the face or head.