title: Endoscopic endonasal transsphenoidal approach to the sellar region: results of endoscopic dissection on 30 cadavers.
abstract: OBJECTIVE
  To recognize the endoscopic anatomy of the surgical corridor along the nasal cavity, sphenoidal sinus and the sellar area to delineate the pure endoscopic endonasal transsphenoidal approach (EETSA) to the region of the pituitary gland.
  
  
  METHODS
  The endoscopic anatomy of the nasal cavity, sphenoid sinus and the sellar region was studied in 30 fresh cadavers (mean age 42.1 / range 18-66) and dissections were performed in a stepwise manner to simulate EETSA to the sellar region.
  
  
  RESULTS
  The sphenoid ostium, located 14.9 mm superior to the choana, was identified at the midpoint between the nasal septum and the superior turbinate in 23 specimens. The shape of the sphenoid ostium was linear (35%), fusiform (30%), oval(22%) or circular (13%). The mean width of the pituitary gland was 14.3 mm and the average minimum distance between the internal carotid arteries on both sides ranged between 13 to 22 mm. Following total hypophysectomy in 12 specimens, the width and length of diaphragma sellae was measured 10.83 and 5.83 mms respectively.
  
  
  CONCLUSIONS
  This study documents that variations are common in nasal, sphenoidal and sellar phases of the trans-sphenoidal approach. Detailed knowledge of the basic anatomical relationships through the view of the endoscope and performing endoscopic dissections in large number of specimens will facilitate the endoscopic surgical procedures and decrease the rate of surgical complications.
authors.affiliation: Istanbul University Cerrahpasa Medical Faculty, Department of Neurosurgery, Istanbul, Turkey.
authors.forename: Bashar
authors.initials: B
authors.lastname: Abuzayed
authors.forename: Necmettin
authors.initials: N
authors.lastname: Tanriöver
authors.forename: Fatma
authors.initials: F
authors.lastname: Ozlen
authors.forename: Nurperi
authors.initials: N
authors.lastname: Gazioğlu
authors.forename: Mustafa Onur
authors.initials: MO
authors.lastname: Ulu
authors.forename: Ali Metin
authors.initials: AM
authors.lastname: Kafadar
authors.forename: Berna
authors.initials: B
authors.lastname: Eraslan
authors.forename: Ziya
authors.initials: Z
authors.lastname: Akar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002102:Cadaver; D004210:Dissection; D004724:Endoscopy / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D009296:Nasal Cavity / Q000033:anatomy & histology / Q000601:surgery; D019635:Neurosurgical Procedures / Q000379:methods*; D012658:Sella Turcica / Q000033:anatomy & histology* / Q000601:surgery*; D019291:Skull Base / Q000033:anatomy & histology / Q000601:surgery; D013100:Sphenoid Bone / Q000033:anatomy & histology* / Q000601:surgery*; D055815:Young Adult