"Keyhole" brain surgery describes procedures performed through a small opening — sometimes through the nostril, sometimes through a small opening in the skull — using an endoscope, a thin instrument with a camera and light at its tip, rather than the wide exposure traditional craniotomy requires.
It is not suitable for every brain condition. The technique works best for tumours in accessible locations, particularly around the pituitary gland and skull base, and for some vascular lesions. Where it is suitable, the benefits are meaningful: less disturbance to healthy brain tissue, often a shorter hospital stay, and a faster return to normal activity than an equivalent open procedure.
Success depends heavily on matching the technique to the right case — a tumour's size, location and relationship to surrounding nerves and blood vessels all factor into whether an endoscopic approach is appropriate, or whether an open approach remains the safer choice. That assessment is where a detailed pre-operative work-up, including targeted imaging, matters as much as the surgery itself.