Transseptal approaches for pituitary surgery.

Our experience with over 147 operations for pituitary disease has given us an opportunity to use and evaluate four separate transseptal approaches. Three approaches have been described previously in the literature: the sublabial transseptal, the open rhinoplasty, and the alotomy with anterior septal dissection. The fourth approach, alotomy with posterior septal dissection, is described here. The advantages and disadvantages of each are discussed, as are the complications of transseptal surgery. A working knowledge of the various transseptal approaches to the pituitary is imperative for the otolaryngologist who participates in pituitary surgery.