Intranasal approaches for pituitary area tumors. Our experience

Transsphenoidal approach is the most commonly employed surgical technique for the resection of pituitary tumors. We present our experience in the transnasal-transsphenoidal approach in 30 patients undergoing pituitary surgery from 1998 to 2002. Ten patients underwent surgery via a sublabial-transeptal-transsphenoidal approach, 15 patients via a transeptal-transsphenoidal approach and 5 patients via a pure endoscopic transnasal-transsphenoidal. The pathological study showed 29 pituitary adenomas and 1 Rathe's cleft cyst. We conclude that the pure endoscopic transnasal-transsphenoidal approach guided by a navigator-system is safest and more effective approach. We reserved the transeptal-transsphenoidal approach for cases with obstructive septal deflection and poor pneumatized sphenoid sinuses. We do not recommend the use of the sublabial-trans-sphenoidal approach.