Skull Base 2011; 21(5): 335-342
DOI: 10.1055/s-0031-1280682

© Thieme Medical Publishers

Endoscopic Endonasal Infrasellar Approach to the Sellar and Suprasellar Regions: Technical Note

Alessandro Paluzzi1 , Juan C. Fernandez-Miranda1 , Carlos Pinheiro-Neto2 , Victor Alcocer-Barradas1 , Beatriz Lopez-Alvarez1 , Paul Gardner1 , Carl Snyderman1 , 2
  • 1Department of Neurological Surgery, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
  • 2Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
Further Information

Publication History

Publication Date:
09 June 2011 (online)


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.


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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