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Updated: Feb 28, 2026
Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
Endoscopic One-Nostril Transseptal Transsphenoidal Approach for Pituitary Tumors: Back to the Past-A Multi-Center
Denis Aiudi1, Alessio Iacoangeli1,2, Andrea Mattioli1
1Neurosurgical Department, Marche Polytechnic University, Azienda Ospedaliero Universitaria delle Marche, 60126 Ancona, Italy.
Objective:
Endoscopic endonasal transsphenoidal pituitary surgery is a diffuse and well-established surgical technique: over the years, the transseptal approach via a nasal mucosal incision has also gained popularity. Here we describe our preliminary experience with an entirely endoscopic one-nostril transseptal transsphenoidal approach (EONOTTA) for pituitary sellar tumor resection; the surgical corridor runs through the entire length of the nasal septum via an incision in the nasal mucosa.
Methods:
A total of 40 patients with a midline prevalent pituitary tumor who underwent EONOTTA from January 2022 to June 2023 were retrospectively reviewed for the evaluation of the safety and efficacy of this technique.
Results:
At 1 year follow-up, all patients had no recurrence, and the degree of tumor resection was comparable to that of the control group undergoing the traditional endoscopic endonasal approach. A low rate of nasal and post-surgical complications occurred; globally, EONOTTA was not time-consuming, and a better functional result was noticed, with a better quality of life for patients.
Conclusions:
This study confirms, in our preliminary experience, the EONOTTA's excellent risk-benefit ratio in selected cases; for an experienced multidisciplinary team, it provides a good maneuverability and a functional outcome while preserving the integrity of the nasal mucosa.
