title: Mononostril endoscopic transsphenoidal approach to sellar and peri-sellar lesions: Personal experience and literature review.
abstract: OBJECTIVE
  The endonasal endoscopic approach to skull base is still under investigation. The main goal is the minimal invasive approach to pathologies with a better rate of resection without retraction of the brain tissue. Here, the authors report their technique of transnasal endoscopic neurosurgery using a mononostril approach and its development.
  
  
  METHODS
  The supplementary video demonstrates the different steps of the mononostril approach and resection of a pituitary adenoma. All video-recorded procedures that were carried out between 2000 and 2013 using this technique were analysed. The patients were followed prospectively.
  
  
  RESULTS
  Visualization and handling were good in 246/251 (98%). In three cases, we had to switch to microscopy because of severe bleeding of the cavernous sinus. On follow-up, magnetic resonance imaging revealed radical tumour resection in 92% of all cases when intended. There was no mortality, and the low complication rate was remarkable.
  
  
  CONCLUSIONS
  Our mononostril approach of transnasal transsphenoidal surgery shows better results compared with previously published reports in regards to radicality, low cerebrospinal fluid leaks and morbidity. The very low rate of nasal complains is particularly remarkable.
authors.affiliation: a Department of Neurosurgery , Saarland University , Homburg , Germany.
authors.forename: Joachim
authors.initials: J
authors.lastname: Oertel
authors.forename: Michael R
authors.initials: MR
authors.lastname: Gaab
authors.forename: Christoph A
authors.initials: CA
authors.lastname: Tschan
authors.forename: Stefan
authors.initials: S
authors.lastname: Linsler
mesh_terms: D000236:Adenoma / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D057605:Natural Orifice Endoscopic Surgery / Q000009:adverse effects / Q000379:methods*; D044583:Neuroendoscopy / Q000009:adverse effects / Q000379:methods*; D010911:Pituitary Neoplasms / Q000601:surgery*; D012658:Sella Turcica / Q000473:pathology / Q000601:surgery*; D013101:Sphenoid Sinus / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult
keywords: anterior skull base; endoscopy; pituitary surgery; transsphenoidal approach