Minimally invasive nasal neurosurgery for brain tumors

Pituitary adenomas are one of the most frequent tumors in neurosurgery, representing 10-15% of all intracranial tumors.

Endoscopic endonasal surgery is currently the technique of choice in the treatment of this type of tumor. This technique originated at the end of the 1990s. It involves an endoscopic approach through the nostrils without the need for incisions, rupture of the nasal septum or dissection of the nasal mucosa. This type of intervention allows better visualization of the pituitary gland and the tumor. Its benefits have a direct impact on the patient: it significantly reduces local complications (septum perforation, cacosmia, gingival anesthesia, anosmia, etc.), reduces surgical time, offers greater comfort (absence of postoperative nasal packing and reduction of postoperative pain), reduces the average postoperative stay to only 24 – 48 h in centers with great experience with this technique and considerably improves the healing rate. An important factor for the successful performance of this type of intervention is the experience of the neurosurgeon. It is internationally recognized that these surgeons must have a minimum experience of 100 cases and more than 25 cases per year to maintain adequate skills.

This technique has allowed access through the nose, without the need for craniotomies (transcranial approaches), to more complex skull base tumors such as meningiomas, craniopharyngiomas, chordomas and chondrosarcomas. Our group has been the first in the world to clip a ruptured vertebral artery aneurysm through the nose.

Minimally invasive neurosurgery is currently a breakthrough, allowing us to operate on brain tumors through the nose, not having to manipulate the brain and reducing the number of complications in our patients.