Endoscopic nose, sinus and skull base surgery unit

The eye orbit is located very close to the nasal cavity and sinuses. In recent years, following the development of endoscopic surgeries, procedures in the area of the eye can be performed through the nose. These include tear duct surgeries, orbital decompression surgeries, thyroid gland disease-related surgeries and some orbital tumor surgeries.

The endoscopic technique allows more direct access to the affected area through the nasal cavity (the sinuses), and also eliminates the need for an external incision. This requires close cooperation between the ophthalmologist and ENT surgeon, while the patient benefit from interdisciplinary consultation and treatment.

The skull base is actually the floor of the brain. Its front section forms the roof of the nose and sinus cavities. Traditionally, diseases and tumors of the skull base were treated by a neurosurgeon. In the past two decades, endoscopic nasal and sinus surgeries have developed, and in recent years, sinus surgeons discovered that it is possible to reach diseases and tumors at the skull base through the nasal cavities, and thus eliminate the need to obtain access through scalp, removing the need for skull incisions in those places. In some cases, invasive procedures to obtain access to these lesions through the scalp may cause edema or other damage.

A productive collaboration has developed between neurosurgeons and ENT surgeons, where the endoscopic surgeries are performed by both surgeons, using four hands, through both nostrils, enabling precise view of the lesions, lesion correction or total removal. Common deficiencies that may impede such procedures are cerebrospinal fluid leaks and skull base tumors, and particularly pituitary gland tumors.

Mechanical obstruction of the nasal passages (septum deviation, auricular enlargement and sinusitis) often involves changes in the external structure of the nose. Often, the patient seeks to address both the internal and external defect, and often, doctors are the ones who recommend the combination of external and internal surgery. The patient is interested that the inner part will be treated by a doctor who specializes in internal rhinoplasty, and the outer part will be treated by a doctor who specializes in external rhinoplasty, plastic surgery.
Instead of splitting the surgeries or compromising on the standard of one of the steps of the surgery, Dr. Roee Landsberg and Dr. Aharon Amir work together, and perform integrated surgeries.