ABSTRACT
We report a technical variation of the endoscopic endonasal approach to the sellar
and suprasellar regions which relies on the use of a 45-degree angled endoscope. The
so-called “infrasellar approach” aims at excising lesions situated within the intermediate
and posterior lobes of the pituitary gland without damaging the anterior lobe, thus
potentially minimizing endocrinological morbidity. In this regard the endoscopic infrasellar
approach might be advantageous in selected cases when compared with the traditional
transsphenoidal approach with the microscope. We describe the technique and illustrate
it with representative clinical cases.
KEYWORDS
Endoscopic endonasal approach - infrasellar approach - 45-degrees angled endoscope
- Rathke's cleft cysts - Cushing disease - hypothalamic pilocytic astrocytoma
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Juan C Fernandez-MirandaM.D.
Department of Neurological Surgery, University of Pittsburgh Medical Center
200 Lothrop Street, PUH B400, Pittsburgh, PA 15213
Email: fernandezmirandajc@upmc.edu