Abstract
Background
The use of endoscopes in transnasal surgery offers increased visualization. To minimize rhinological morbidity without restriction in manipulation, we introduced the mononostril transethmoidal-paraseptal approach.
Methods
The aim of the transethmoidal-paraseptal approach is to create sufficient space within the nasal cavity, without removal of nasal turbinates and septum. Therefore, as a first step, a partial ethmoidectomy is performed. The middle and superior turbinates are then lateralized into the ethmoidal space, allowing a wide sphenoidotomy with exposure of the central skull base.
Conclusions
This minimally invasive transethmoidal-paraseptal approach is a feasible alternative to traumatic transnasal concepts with middle turbinate and extended septal resection.
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Prof. Dr. med. R. Reisch and KD Dr. med. H. R. Briner are consultants of Karl Storz GmbH, Tuttlingen, Germany.
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The video “trans-ethmoidal, paraseptal approach to the sella” illustrates the main steps of a minimally invasive, mono-nostril approach to the sella preserving the middle turbinate and the septum, yet allowing a mono-nostril bimanual resection. (MP4 299966 kb)
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Reisch, R., Briner, H.R. & Hickmann, AK. How I do it: the mononostril endonasal transethmoidal-paraseptal approach. Acta Neurochir 159, 453–457 (2017). https://doi.org/10.1007/s00701-017-3075-6
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DOI: https://doi.org/10.1007/s00701-017-3075-6