History of EEA at UPMC
The base of the skull has been one of the most challenging anatomic regions to access. Before the recent advances in endoscopic transnasal brain surgery, procedures in the 1980s and early 1990s involved making extensive skin incisions and removing large bony structures to reach deep into the base of the skull. Such craniofacial approaches could be cosmetically disfiguring and involved the manipulation of important neural tissue — the brain and cranial nerves (including the optic and oculomotor nerves).
UPMC physicians began investigating endoscopic transnasal brain surgery in 1998 and spent the next several years in painstaking research. Neurosurgeon Amin Kassam, MD, and otolaryngologists Ricardo Carrau, MD and Carl Snyderman, MD, understood the importance of combining their fields of brain surgery and head and neck surgery at both the lab bench and in the operating room. They mapped out the anatomy of the undersurface of the brain and skull base and collaborated with industry partners to fabricate new surgical tools.
Refined technique and successful treatment
By 2000, the surgeons began working endonasally in tandem in the operating room on large pituitary tumors, refining their skills and successfully expanding to other skull base locations from the nasal cavity through the leather-like dura, or lining of the brain, to further areas around and in the brain.
They also proved they could better control surgical bleeding, no matter how buried or contorted a tumor or growth was. With the evolution and refinement of the expanded endonasal approach (EEA) technique, patients with deep-seated skull base tumors or other conditions who once faced extensive surgery, or were told there was no surgical treatment to help them, now have an excellent chance of successful outcomes and full recovery.
To learn more about EEA at MINC, or to request a consultation, go to Appointments & Referrals.