EEA Questions & Answers
Q: What is the Endoscopic Endonasal Approach (EEA)?
A: The Endoscopic Endonasal Approach is a minimally invasive procedure refined by Drs. Paul Gardner and Carl Snyderman to remove brain tumors. The EEA is done transphenoidally (going through the nose) using a telescope called an endoscope. A small area at the base of the skull is removed to allow direct and targeted access directly at the tumor without manipulating the brain. The concept of 'inside out surgery' – starting directly at the tumor and working outward avoids the need to move critical structures in order to get to the tumor.
Q: What was the more traditional approach?
A: The traditional approach involves transcranial approaches where a portion of the skull was removed to gain access to the brain. Often components of the facial skeleton need to be removed in order to gain access to the tumor. This represents the 'outside-in' approach requiring the manipulation of critical vital structures before getting to the tumor. Instead of working from the inside out with the EEA you are now working from the outside in, therefore these vital structures often need to be moved in order to access the tumor.
Q: How long does surgery take?
A: It can be variable. For routine cases often two hours from the time you are administered anesthesia. More complex cases can take longer from 4-6 hours.
Q: Is the surgery painful?
A: From speaking with patients post-operatively, it appears to be much less painful and much less uncomfortable then comparable conventional approaches. The most common complaint is the post-operative nasal packings. They are removed within 1-3 days.
Q: Where do I go from there?
A: After you leave the recovery room you are transported up to 5G, which is a step down unit.
Q: When can I see my family?
A: Once you are awake and oriented and in the step down unit, your family will be notified and they can join you at your bedside.
Q: How long will I will be hospitalized?
A: After your post-operative condition is reviewed, including blood work and general well being, usually two days.
Q: When can I return to work?
A: This can be variable and depends on whether the lining of the brain is violated. If it is not often the patient can return to work within days. If it is violated we generally would like to avoid heavy lifting for a few weeks in order to allow for the reconstruction to seal. This can be sooner depending on your type of employment. These issues can be discussed with our team upon follow up and a firm decision will be given at that time.
Q: What about my insurance coverage?
A: The coordinator who is scheduling your surgery will be responsible for contacting your insurance company and arranging prior authorization if required. All aspects of your insurance coverage will be discussed with you prior to surgery.