Endoscopic Endonasal Skull Base Surgery
Endoscopic endonasal surgery uses the nostrils as a natural corridor to the pituitary and the center of the skull base. Working together with a rhinology (ENT) surgeon, Dr. Daggubati removes tumors and repairs leaks under high-definition endoscopic vision with no external incision, no brain retraction and no hair removal.
Keyhole approaches behind the ear or through the eyebrow complement the endonasal route for tumors of the lateral skull base, including vestibular schwannomas and microvascular decompression for trigeminal neuralgia.
Who it is for
- Pituitary adenomas, Rathke’s cleft cysts, craniopharyngiomas
- Skull base meningiomas and chordomas
- CSF leaks and encephaloceles
- Vestibular schwannoma (retrosigmoid keyhole)
- Trigeminal neuralgia / hemifacial spasm (microvascular decompression)
Why we use it
- No external incision
- No brain retraction
- Panoramic endoscopic view around corners
- 1–2 night hospital stay for most pituitary surgery
How the procedure is done
- ENT creates the nasal corridor and opens the sphenoid sinus.
- The bone over the tumor is removed and the tumor resected with angled endoscopes.
- The skull base is reconstructed with the patient’s own tissue (nasoseptal flap) when needed.
- No nasal packing in most cases; overnight monitoring.
Recovery
Nasal congestion and crusting for several weeks; sinus rinses; no nose-blowing or heavy lifting for 2–4 weeks. Endocrine follow-up after pituitary surgery.
Risks, stated plainly
CSF leak, sinus problems, hormone disturbance (temporary diabetes insipidus is common after pituitary surgery), bleeding, infection, vision or cranial nerve injury (rare). Dr. Daggubati reviews the specific risks for your situation in person before any decision is made.
Preparing for this surgery
Dr. Daggubati has written detailed guides for this procedure covering medications to stop, prehabilitation, the day of surgery, and a week-by-week recovery timeline.