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Background and Objectives:Transseptal TSA (transsphenoidal approach) has advantages of wide exposure, good operative view, and use of two hands, but has disadvantages of external nasal scar, posibility of external nasal deformity and severe nasal pain. And endoscopic TSA can reduce nasal morbidity, but operator cant use two hands with the endoscope and it also has endoscopic TSA. Subjects and Method:We reviewed 112 patients who had been operated with this method from Mar, 2001 to Sep, 2003. Details of surgical technique of this approach are presented. We investigated the operative time, hospital periods, and complications. Results:The mean operative time was 95 minutes. Nasal packings were removed on the first postoperative day in 106 cases, and on second postoperative days in 6 cases. The mean postoperative hospital stay was 3.2 days. During the fo-low-up periods (6- 24 months, mean 13.5 months) (4 cases), nasal septal deviation (2 cases), epistaxis (1 case), nasal septal perforation (1 case), CSF leakage (1 case), hypopituitarism (3 cases), and diabetes insipidus (4 cases). Meningitis, external nasal deformity, external scar, paresthesia or sinusitis were not noticed. Con-clusion:Using endonasal TSA, we could operate easily with two hands, obtaining a good operative view and short operation (Korean J Otorhinolaryngol-Head Neck Surg 2007 ;50 :590-5)

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