[Trans-septo-sphenoidal transnasal approach for microsurgery of hypophyseal tumors]

The surgical treatment of hypophyseal tumors has improved from external approach (transcranial-subtemporal) to the trans-septo-transphenoidal approach. Since the last thirty years this way to access has been increasingly used, because it provides an excellent exposure, little bleeding, is rapidly and easily performed with less morbi-morality and has smoother postoperative period. A retrospective study of 16 patients whose hypophyseal tumors were treated surgically using the trans-septo-sphenoidal transnasal (maxillary-premaxillary) approach is presented. All these patients were seen in the E.N.T. Department of Alicante's General University Hospital, between January 1990 and June 1993. The trans-septo-sphenoidal transnasal via avoids some of the problems of the sublabial trans-sphenoidal procedure; namely longer operating time, oral contamination of the surgical field, subsequence difficulties due to the lack of sensibility and discomfort of the upper jax area and postoperative alterations in the projection of the septal-columelar tip.