The importance of brain tumor surgery through the nose The importance of this brain tumor operation lies in the reduction of surgical injuries and faster recovery of patients. Unlike open surgery, which requires a wide opening in the skull, this method allows tumor removal using the nasal route and minimizes complications such as infection, bleeding, and prolonged hospitalization. Patients usually feel less pain and return to daily activities more quickly. In addition, the aesthetic appearance is maintained because there is no need for external cutting. For this reason, today this operation is used in neurology centers as an advanced technique and a global standard. ### Why is nasal surgery chosen? Nasal surgery is considered a major evolution in neurosurgery due to its minimal invasiveness and direct access to skull base tumors. **Brain tumor surgery** is performed through the nose without making large incisions and damage to healthy brain tissues, and the risk of bleeding and infection is minimized. In this method, patients experience less pain, the recovery period is shorter, and a quick return to daily life is possible. In addition to the above points, cosmetic appearance is preserved and surgeons with direct endoscopic vision can perform surgery with extreme precision, so that many sensitive and complex tumors are successfully removed. What tumors are suitable for this method? Not all brain tumors can be treated with this technique. This method is more suitable for tumors that are located in the central parts and near the base of the skull. Pituitary adenoma, as the most common type, can be easily removed through the nose with the help of an endoscope. Also, some benign tumors such as craniopharyngioma or cysts near the pituitary gland and sphenoid sinus are also treated with this method. In some cases, small skull base meningiomas can also be removed with this technique. The choice of this method depends on the size, location and spread of the tumor and requires a careful evaluation by a specialist doctor. ### Types of tumors near the sinuses and the base of the skull Tumors that grow in the areas near the sinuses and the base of the skull can often be treated with endoscopic surgery due to direct access through the nose. Due to the proximity of these tumors to vital structures, they require high precision and the selection of the appropriate surgical method. - Pituitary adenoma: the most common tumor that can be removed by endoscopy, it is usually benign. - Craniopharyngioma: a rare tumor in children and adults that is close to the base of the skull. Meningioma of the base of the skull: in small and medium sizes, it can be removed through the nose. - Cysts and benign sinus lesions: such as Rathke's cyst, which are removed without open surgery. ### Size, location, and accessibility matter The size, location, and accessibility of the tumor play a decisive role in the selection of nasal brain tumor surgery. Small and medium-sized tumors located in the central areas of the skull base and near the pituitary gland are the best option, because the surgeon can remove them completely with minimal invasiveness and direct endoscopic vision. Large, extensive, or lateral tumors may require an open approach. Proximity to vital vessels and nerves also limits access, and careful decision-making and advanced preoperative imaging are essential to reduce the risk of complications. Advantages and disadvantages of nasal surgery compared to open procedures Nasal surgery is a minimally invasive procedure that offers many advantages over open surgery. This technique reduces the risks of opening the skull, has a shorter recovery period and less pain, but there are limitations in the size and type of tumor and not all lesions can be removed with it. Postoperative care of brain tumor through the nose Care after transsphenoidal brain tumor surgery is critical to ensure proper recovery and prevent possible complications. According to established guidelines, patients should avoid activities that increase intracranial pressure, such as lifting heavy objects, bending over, sneezing, or coughing with the mouth closed. Also, it is recommended that patients such as **awake brain surgery** avoid driving while taking strong pain medication or have vision problems. In an article published in the journal *Endocrine Practice* it is stated: "All patients require immediate postoperative monitoring for corticosteroid hypofunction and water metabolism disorders." **Summary** The minimally invasive method of brain tumor surgery through the nose is an advanced method that improves the quality of life of patients by reducing complications, less pain, and a shorter recovery period. The success of this operation directly depends on the accuracy, experience and skill of the surgeon, because the correct choice of method, accurate tumor assessment and control of postoperative complications are of vital importance. In this context, Dr. Yazdan Panahi is known as one of the leading specialists in neurosurgery and endoscopic skull base surgery in Iran, and with years of experience and the use of modern techniques, he provides the best treatment results for patients.