Esthesioneuroblastoma (ENB)

Esthesioneuroblastoma (ENB) is an extremely rare tumor that develops in the nose. Treatment options may include skull base surgery or endoscopic endonasal surgery. At Columbia’s Skull Base Tumor Center, our neurosurgeons offer particular expertise in the surgical options available for removal of ENBs.

This tumor also goes by the name olfactory neuroblastoma because it arises from olfactory nerve cells, which are located in the upper part of the nasal cavity, adjacent to the base of the brain. This location makes ENBs one type of skull base tumor.

In general, ENBs grow slowly. ENB generally has a good prognosis if the tumor is small and has not metastasized to other parts of the body.


As an ENB grows, the tumor tissue fills the upper nasal cavity so that most patients experience nasal obstruction. Frequent epistaxis is also common. Additional symptoms may include:

  • Anosmia
  • Sinusitis
  • Nasal discharge
  • Facial pain

Changes in vision, ear pain and headache may indicate the ENB has spread to other regions of the body.


To diagnose an ENB, a physician will start by performing a physical examination. During the examination, a physician may use a tool called an endoscope to see inside the nose.

Imaging tests are then used to determine the exact location of the tumor and whether it has spread to other areas. A computed tomography (CT) scan, a magnetic resonance (MRI) scan, or both, may be needed.

A biopsy is performed to confirm a diagnosis. The tissue sample is viewed under a microscope and evaluated using additional laboratory tests. These procedures can confirm whether the tumor is an ENB.

Risk Factors

The cause of ENB is unknown and continues to be researched.

First reported in 1924, ENB has been found in only about 1,200 people, making this tumor very rare.

ENBs can occur at any age, but they occur most often in adults.


Treatments for skull base tumors such as ENBs have vastly improved over the years. Some ENBs that were previously considered impossible to extract are now removed, with good outcomes. The treatment approach requires a team of expert specialists that includes a neurosurgeon. Our experienced neurosurgeons work with other Columbia specialists to provide patients with the highest-quality treatment and best possible outcomes.

The first step in treatment is surgery. The goal of surgery is to remove as much of the ENB as possible without damaging important tissue and nerves nearby. Advances in surgical technology allow the neurosurgeon and the rest of the team to choose one of two ways to remove the tumor. The methods differ in the route taken to reach the tumor: through the brain or through the nose.

In traditional skull base surgery, the neurosurgeon removes the tumor through the brain. After performing a craniotomy, the neurosurgeon gently lifts and positions the brain out of the way to access the base of the brain and nasal cavity and remove the tumor.

  • In endoscopic endonasal surgery, the neurosurgeon removes the tumor through the nose. This surgery is a minimally invasive procedure, in which the neurosurgeon and team of specialists insert the endoscope through a nostril, allowing them access to the tumor. Using small, specialized instruments, surgeons perform the entire surgery and remove the tumor through the nostril. Because the incisions used in this procedure are smaller than those in traditional brain tumor surgery, healing and recovery are faster, and complications are fewer.

After surgery, treatment consists of radiation therapy and sometimes chemotherapy to eliminate any remaining tumor.

Each patient’s tumor is unique. Our neurosurgeons, along with a team of highly trained additional specialists, will evaluate each case and recommend the best course for each individual.