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Skull base surgery. 1991 July; 1(3): 177–182.
PMCID: PMC1656293

Transpalatal Transsphenoidal Approach to the Sella in Children


The sublabial transseptal transsphenoidal approach provides excellent exposure for pituitary surgery in adults. However, sellar lesions in children are more difficult to approach because of the smaller size of the pyramidal aperture and because of the limited pneumatization of the sella. We resurrected the transpalatal transsphenoidal approach for the treatment of sellar lesions in three children (one adenoma and two cystic craniopharyngiomas). The advantages of this approach were a short working distance and a wide exposure that permitted extensive drilling of the poorly pneumatized sphenoid bone under direct vision. The technique successfully provided exposure for management of the sellar pathology in all three cases and resulted in no nasal or palatal defects.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • HIRSCH O. Symptoms and treatment of pituitary tumors. AMA Arch Otolaryngol. 1952 Mar;55(3):268–306. [PubMed]
  • Kennedy DW, Cohn ES, Papel ID, Holliday MJ. Transsphenoidal approach to the sella: the Johns Hopkins experience. Laryngoscope. 1984 Aug;94(8):1066–1074. [PubMed]
  • Eisele DW, Flint PW, Janas JD, Kelly WA, Weymuller EA, Jr, Cummings CW. The sublabial transseptal transsphenoidal approach to sellar and parasellar lesions. Laryngoscope. 1988 Dec;98(12):1301–1308. [PubMed]
  • TRIBLE WM, MORSE AE. TRANSPALATAL HYPOPHYSECTOMY. Laryngoscope. 1965 Jul;75:1116–1122. [PubMed]
  • Lüdecke DK, Herrmann HD, Schulte FJ. Special problems with neurosurgical treatments of hormone-secreting pituitary adenomas in children. Prog Exp Tumor Res. 1987;30:362–370. [PubMed]
  • Lee KJ. The sublabial transseptal transsphenoidal approach to the hypophysis. Laryngoscope. 1978 Jul;88(7 Pt 2 Suppl 10 Suppl):–65. [PubMed]

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