How I do it: the mononostril endonasal transethmoidal-paraseptal approach

• DOI: 10.1007/s00701-017-3075-6
• Publication Date: 2017-01-18T03:13:21Z
• Authors: Robert Reisch; Hans Rudolf Briner; Anne-Katrin Hickmann
• Keywords: 03 medical and health sciences; 0302 clinical medicine; Ethmoid Sinus; Sphenoid Sinus; Humans; Pituitary Neoplasms; Skull Base Neoplasms; Transanal Endoscopic Surgery

The use of endoscopes in transnasal surgery offers increased visualization. To minimize rhinological morbidity without restriction in manipulation, we introduced the mononostril transethmoidal-paraseptal approach.The aim of the transethmoidal-paraseptal approach is to create sufficient space within the nasal cavity, without removal of nasal turbinates and septum. Therefore, as a first step, a partial ethmoidectomy is performed. The middle and superior turbinates are then lateralized into the ethmoidal space, allowing a wide sphenoidotomy with exposure of the central skull base.This minimally invasive transethmoidal-paraseptal approach is a feasible alternative to traumatic transnasal concepts with middle turbinate and extended septal resection.