Transantral transsphenoidal approach to the pituitary

Hoyt, Thomas E.; Turnbull, Frederick M.; Kusske, John A.

doi:10.3171/jns.1983.59.6.1102

Cited by 4 publications

(1 citation statement)

References 7 publications

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“…14 The transethmoidal approach and the transmaxillary approach have been reported to be modifications of the sphenoidal approach designed to reach this region, but they have the following disadvantages: a facial incision is needed, bleeding cannot be neglected, and the surgical orientation is not easy to determine because of the oblique approach. 2,4,6,7,9,16,18,22,25 Although transnasal posterior ethmoidectomy is also performed by otorhinolaryngologists, this procedure requires an intranasal maneuver. 27 One of the advantages of the transsphenoidal approach is that the nasal mucosa can remain intact to avoid direct contact with bacterial flora in the nasal cavity.…”

Section: Discussionmentioning

confidence: 99%

Extended transsphenoidal approach with submucosal posterior ethmoidectomy for parasellar tumors

Kitano¹,

Taneda²

2001

Journal of Neurosurgery

118

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The authors have developed an extended transsphenoidal approach with submucosal posterior ethmoidectomy for resection of tumors located in the cavernous sinus or the suprasellar region that are difficult to remove via the conventional transsphenoidal approach. Surgery was performed using this approach in 14 patients with large pituitary adenomas, three patients with craniopharyngiomas, and one patient with a meningioma of the tuberculum sellae. The submucosal dissection of the nasal septum used in the conventional transsphenoidal approach was extended to the superior lateral wall of the nasal cavity to expose the bony surface of the superior turbinate lying under the nasal mucosa. Submucosal posterior ethmoidectomy widened the area visualized through the conventional transsphenoidal approach both superiorly and laterally. This provided a safer and less invasive access to lesions in the cavernous sinus or the suprasellar region through the sphenoid sinus. Using this approach the authors encountered no postoperative complications, such as olfactory disturbance, cranial nerve palsy, or arterial injury. In this article the authors present the surgical methods used in this approach.

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Section: Discussionmentioning

confidence: 99%

Extended transsphenoidal approach with submucosal posterior ethmoidectomy for parasellar tumors

Kitano¹,

Taneda²

2001

Journal of Neurosurgery

118

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A lateral rhinotomy approach to transsphenoidal hypophysectomy

Petruson

Elversson

1988

Clin Otolaryngol

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The transsphenoidal approach to the sella turcica is nowadays more often used than the transcranial. The disadvantages of the transantral and transseptal approaches are a narrow and distant operative field and various complications. A fluoroscope often has to be used for orientation. With our lateral rhinotomy technique, no fluoroscope is needed as the whole sphenoid can be inspected. Furthermore, the operative field is wide and closer to the surgeon, few instruments are needed, bleeding is easily controlled, the anterior wall of the sella can be properly sealed, CSF rhinorrhoea prevented and the sphenoidal mucosa restored. The whole operation can be performed within 2 h. Fifty-seven patients were operated upon with good results and few complications.

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Approaches to the sellar and parasellar region: Anatomic comparison of endonasal– transsphenoidal, sublabial–transsphenoidal, and transethmoidal approaches

Das

Spencer

Nwagwu

et al. 2001

Neurological Research

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Various surgical approaches have been described for treating lesions which arise in the sellar region. The popular transnasal-transsphenoidal and transethmoidal-transsphenoidal approaches avoid the morbidity associated with transcranial operations while allowing enough exposure to successfully remove most lesions that arise in and around the sella. The goal of the present study was to accurately quantify the amount of exposure to the sellar and suprasellar region that the transethmoidal-transsphenoidal, endonasal-transphenoidal, and sublabial-transsphenoidal approaches provide. Each of the three approaches was performed on 14 formalin fixed heads with the aid of the operative microscope. The distances of relevant surgical landmarks, and the amount of exposure superior and anterior to the dorsum sella as well as the lateral exposure obtained through each of these approaches was carefully recorded. The mean distances were then used to calculate the volume of exposure offered by each approach. It was found that the sublabial-transsphenoidal approach afforded the greatest volume of exposure superior and anterior to the dorsum sella. The endonasal-transsphenoidal and the transethmoidal approaches were both found to offer less suprasellar volume exposure, with the transethmoidal approach offering the least. The authors believe the information obtained through this study illustrates some important anatomical relationships which can be used to advantage by the surgeon to tailor the most appropriate approach, depending upon the precise location of the lesion either within the sella or suprasellar region.

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Transantral transsphenoidal approach to the pituitary

Abstract: The authors describe the technique of a transantral transsphenoidal approach to the sella turcica. The advantages and potential complications are discussed. This procedure may also be applicable when dealing with tumors of the skull base and orbits.

Cited by 4 publications

References 7 publications

Extended transsphenoidal approach with submucosal posterior ethmoidectomy for parasellar tumors

Extended transsphenoidal approach with submucosal posterior ethmoidectomy for parasellar tumors

A lateral rhinotomy approach to transsphenoidal hypophysectomy

Approaches to the sellar and parasellar region: Anatomic comparison of endonasal– transsphenoidal, sublabial–transsphenoidal, and transethmoidal approaches

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