Anatomy of the Sellar Region

Abstract

The transseptal transsphenoidal approach to the pituitary is made through the nasal septum, whose mucosa and periosteum are stripped on only one side if possible to avoid atrophic rhinopathy. Figure SA 20 (from Lang and Baumeister) presents data on the size of the piriform aperture, at whose lower border the anterior nasal spine can be removed. In several studies we have determined the distance between the zone below the anterior nasal spine (subspinal zone) to the aperture of the sphenoid sinus, finding a mean value of 53.7 (43–64) mm in adults. The arteries of the nasal septum are shown in Fig. SA 21 (from Lang 1985). The anterior inferior part of the nasal septum is generally supplied by the anterior inferior septal branch of the superior labial artery (Lang and Schulz 1985).