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Related Experiment Video

Updated: Jul 18, 2026

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Extended Transsphenoidal Approach with Sigma-shape Osteotomy of the Maxilla: Technical Note.

Y Sawamura, S Terasaka, T Fukushima

    Skull Base Surgery
    |December 16, 2006
    PubMed
    Summary

    A novel Sigma-shape osteotomy technique expands the surgical window for transsphenoidal surgery. This enhanced access improves visualization of midline lesions from the planum sphenoidale to the lower clivus.

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    Area of Science:

    • Neurosurgery
    • Surgical Anatomy

    Background:

    • The traditional sublabial transsphenoidal approach has limitations in operative field exposure.
    • Accessing midline lesions in the sellar and clival regions can be challenging.

    Purpose of the Study:

    • To describe a simple surgical technique to widen the sublabial transsphenoidal window.
    • To enhance access to midline lesions from the planum sphenoidale to the lower clivus.

    Main Methods:

    • Development based on clinical experience and cadaveric dissection.
    • Involved a sublabial incision, bilateral septal mucosa separation, and a Sigma-shape osteotomy of the maxilla.
    • Drilling of nasal crests and incision of the nasopharynx roof.

    Main Results:

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  • Achieved a widened nasal cavity entrance (32-38 mm).
  • No significant sensory loss in incisors despite partial cutting of the anterior superior alveolar nerve plexus.
  • Provided improved extradural access to sellar and clival regions.

    • Conclusions:

    • The extended transsphenoidal approach with Sigma-shape osteotomy is a simple technique.
    • Offers significantly widened access to the sellar and clival regions for surgical intervention.