The transoral transpalatal approach to the pituitary fossa

Transpalatal trans-sphenoidal approaches to the sella turcica were described as early as 1900. Since the advent of effective trans-sphenoidal pituitary microsurgery in the 1960's, the sublabial transnasal approach became the most widely used. We reassessed the transoral transpalatal approach in 1978 and found the procedure to have distinct advantages over the transnasal operation. Between 1978 and 1992, 94 patients had transpalatal trans-sphenoidal explorations of the pituitary fossa at our institution. The detail of the operative technique, the results and the advantages are discussed.