Transseptal approach for the treatment of pituitary lesions
J. R. Escajadillo and E. de Gortari
The transseptal approach is the most logical and adequate technique to
reach the sella turcica and adjacent structures. In the era before the use
of antibiotic and steroid replacement therapy, Harvey Cushing, MD, and
Norman Dott, MD, obtained successful results by using the transseptal
approach to resect and decompress pituitary adenomas. Some authors use the
maxilla-premaxilla technique followed by a sublabial incision through which
they introduce the trans-sphenoidal speculum. The endonasal approach is a
modification of the sublabial incision, but much of the perpendicular plate
of the ethmoid is still removed. Therefore, we have added another
modification that consists in removing only a fragment of the perpendicular
plate of the ethmoid and vomer anterior to the sphenoid rostrum. We also
describe our experience with this technique and analyze our results.