Relaxing incision of nostril sill to expand the transnasal transsphenoidal approach: technical note.

OBJECTIVE

The transsphenoidal approach to the pathology of sellar region is a fundamental procedure in the armamentarium of neurosurgeons. Modern practice tends to prefer various transnasal approaches over the more traditional sublabial route. However, the transnasal approach can be limited by small nares, particularly in the pediatric population.

METHODS

We present a simple relaxing incision in the nostril sill to safely and effectively widen the nostril for the transnasal approach.

RESULTS

The authors have used this technique in 10 pediatric and young adult patients with satisfactory expansion of the transnasal corridor with no cosmetic concerns.

CONCLUSIONS

In our experience, the relaxing incision significantly expands the transnasal corridor and allows easy placement of the self-retaining nasal speculum or endoscopic instruments, is well tolerated by patients, and heals with no cosmetic concerns.