title: Relaxing incision of nostril sill to expand the transnasal transsphenoidal approach: technical note.
abstract: OBJECTIVE
  The transsphenoidal approach to the pathology of sellar region is a fundamental procedure in the armamentarium of neurosurgeons. Modern practice tends to prefer various transnasal approaches over the more traditional sublabial route. However, the transnasal approach can be limited by small nares, particularly in the pediatric population.
  
  
  METHODS
  We present a simple relaxing incision in the nostril sill to safely and effectively widen the nostril for the transnasal approach.
  
  
  RESULTS
  The authors have used this technique in 10 pediatric and young adult patients with satisfactory expansion of the transnasal corridor with no cosmetic concerns.
  
  
  CONCLUSIONS
  In our experience, the relaxing incision significantly expands the transnasal corridor and allows easy placement of the self-retaining nasal speculum or endoscopic instruments, is well tolerated by patients, and heals with no cosmetic concerns.
authors.affiliation: Goodman Campbell Brain and Spine, Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, IN 46202, United States.
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Kim
authors.forename: Aaron A
authors.initials: AA
authors.lastname: Cohen-Gadol
mesh_terms: D000236:Adenoma / Q000601:surgery; D000293:Adolescent; D002648:Child; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D009296:Nasal Cavity / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods*; D047748:Pituitary ACTH Hypersecretion / Q000601:surgery; D010902:Pituitary Gland / Q000601:surgery*; D010911:Pituitary Neoplasms / Q000601:surgery; D013100:Sphenoid Bone / Q000601:surgery*
keywords: Children; Nasal cavity; Neurosurgical procedures; Speculum; Sphenoid sinus; Technique