Surgical Technique - Endoscopic transphenoidal approach

The endoscopic transphenoidal approach is performed through the nostrils. A natural passageway exists at the back end of the nose leading into the sphenoid sinus, which can be enlarged so that the endoscope and instruments can pass into this air-filled cavity. From this region the sella turcica is easily accessed which is the location of pituitary adenomas, craniopharyngiomas and rathke's cleft cyst.

Using the same approach, the endoscope can be directed upwards through the ethmoid sinuses to the base of the frontal lobe. This approach is useful in removing meningiomas as well as tumors that extend into the suprasellar region.

By directing the endoscope downward, the surgeon can easily see the back of the throat and palate to remove tumors of the clivus such as chordomas and chondrosarcomas.

	The endoscopic approach to the anterior skullbase uses the natural openings in the face to avoid any scars.
	This cut-away diagram shows the anatomy encountered during the approach to the anterior skull base.
	Close-up veiw of the relationship of the sinuses with the pituitary gland, carotid arteries and optic nerves.

Videos

	Pituitary Adenoma Watch a video of a pituitary tumor removal.
	Intrasellar Craniopharyngioma Watch a video of a intrasellar craniopharyngioma removal.
	Suprasellar Craniopharyngioma Watch a video of a suprasellar craniopharyngioma removal.
	Suprasellar Rathke's Cleft Cyst Watch a video of a Suprasellar Rathke's Cleft Cyst removal.
	Tuburculum Sella Meningioma Watch a video of a Tuburculum Sella Meningioma removal.
	Orbital Osteoma Watch a video of an osteoma removal .
	CSF leak / Meningocoele Watch a video of a meningocoele repair.
	Clival Chordoma Watch a video of a clival chordoma removal.