[Anatomy of the extended transsphenoidal approach under endoscopy and its application on treating the sellar and parasellar lesion].

OBJECTIVE: The endoscopic surgical anatomy of the extended transsphenoidal approach and its application was studied to establish the anatomic basis for parasellar lesion. METHOD: Four adult cadaveric heads were studied by imitating extended transsphenoidal approach and some anatomic parameters were measured. RESULT: The sphenoid sinus was divided into five compartments by posterior bony wall. The periosteum, dura, cavernous sinus, carotid artery,ocular nerve, trochlea nerve and adduce nerve crossing cavernous sinus could be visualized. After sphenoidal planum was removed, optic nerve, chiasm and pituitary gland could be displayed. A patient with gigantic pituitary adenoma was cured by extended transsphenoidal approach. CONCLUSION: The sellar and parasellar region can be visualized through extended transsphenoidal approach and lesion of sellar turcica can be treated by the approach. Surgeons should be skilled at endoscopic or microscopic sellar anatomy and have experience with transsphenoidal surgery.