{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T00:04:07Z","timestamp":1792022647078,"version":"4.4.0"},"reference-count":30,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JNS"],"published-print":{"date-parts":[[2016,8]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Over the past 2 decades, endoscopy has become an integral part of the surgical repertoire for skull base procedures. The present clinical evaluation and cadaver study compare binostril and mononostril endoscopic transnasal approaches and the surgical techniques involved.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>Forty patients with pituitary adenomas were treated with either binostril or mononostril endoscopic surgery. Neurosurgical, endocrinological, ophthalmological, and neuroradiological examinations were performed. Ten cadaver specimens were prepared, and surgical aspects of the preparation and neuroradiological examination were documented.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>In the clinical evaluation, 0\u00b0 optics were optimal in the nasal and sphenoidal phase of surgery for both techniques. For detection of tumor remnants, 30\u00b0 optics were superior. The binostril approach was significantly more time consuming than the mononostril technique. The nasal retractor limited maneuverability of instruments during mononostril approaches in 5 of 20 patients. Endocrinological pituitary function, control of excessive hormone secretion, ophthalmological outcome, residual tumor, and rates of adverse events, such as CSF leaks and diabetes insipidus, were similar in both groups.<\/jats:p>\n<jats:p>In the cadaver study, there was no significant difference in the time required for dissection via the binostril or mononostril technique. The panoramic view was superior in the binostril group; this was due to the possibility of wider opening of the sella in the craniocaudal and horizontal directions, but the need for removal of more of the nasal septum was disadvantageous.<\/jats:p><\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Because of maneuverability of instruments and a wider view in the sphenoid sinus, the binostril technique is superior for resection of large tumors with parasellar and suprasellar expansion and tumors requiring extended approaches. The mononostril technique is preferable for tumors with limited extension in the intra- and suprasellar area.<\/jats:p><\/jats:sec>","DOI":"10.3171\/2015.6.jns142637","type":"journal-article","created":{"date-parts":[[2016,1,1]],"date-time":"2016-01-01T15:00:18Z","timestamp":1451660418000},"page":"334-345","source":"Crossref","is-referenced-by-count":32,"title":["Binostril versus mononostril approaches in endoscopic transsphenoidal pituitary surgery: clinical evaluation and cadaver study"],"prefix":"10.3171","volume":"125","author":[{"given":"Jens","family":"Conrad","sequence":"first","affiliation":[{"name":"Neurochirurgische Klinik und Poliklinik,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Ayyad","sequence":"additional","affiliation":[{"name":"Neurochirurgische Klinik und Poliklinik,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"W\u00fcster","sequence":"additional","affiliation":[{"name":"Hormon- und Stoffwechselzentrum;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wael","family":"Omran","sequence":"additional","affiliation":[{"name":"Endokrinologische Praxis, Mainz; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias M.","family":"Weber","sequence":"additional","affiliation":[{"name":"Abteilung f\u00fcr Endokrinologie und Stoffwechselerkrankungen, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Moritz A.","family":"Konerding","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Anatomie und Zellbiologie, Fachbereich Medizin, Johannes Gutenberg-Universit\u00e4t Mainz;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wibke","family":"M\u00fcller-Forell","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Neuroradiologie, Universit\u00e4tsmedizin, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alf","family":"Giese","sequence":"additional","affiliation":[{"name":"Neurochirurgische Klinik und Poliklinik,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joachim","family":"Oertel","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Neurochirurgie, Universit\u00e4tsklinikum des Saarlandes, Homburg\/Saar, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"key":"b1-jns142637","series-title":"Endocrine","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1385\/ENDO:28:1:067","article-title":"Treatment of pituitary tumors: surgery","volume":"28","author":"Buchfelder","year":"2005"},{"key":"b2-jns142637","series-title":"Minim Invasive Neurosurg","doi-asserted-by":"publisher","first-page":"66","DOI":"10.1055\/s-2008-1052019","article-title":"Endoscopic endonasal transsphenoidal approach to the sella: towards functional endoscopic pituitary surgery (FEPS)","volume":"41","author":"Cappabianca","year":"1998"},{"key":"b3-jns142637","series-title":"Minim Invasive Neurosurg","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1055\/s-2002-36197","article-title":"Endoscopic endonasal transsphenoidal approach: outcome analysis of 100 consecutive procedures","volume":"45","author":"Cappabianca","year":"2002"},{"key":"b4-jns142637","series-title":"Neurosurgery","doi-asserted-by":"publisher","first-page":"933","DOI":"10.1227\/01.NEU.0000137330.02549.0D","article-title":"Endoscopic endonasal transsphenoidal surgery","volume":"55","author":"Cappabianca","year":"2004"},{"key":"b5-jns142637","series-title":"Pituitary","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1007\/s11102-008-0087-5","article-title":"Endoscopic pituitary surgery","volume":"11","author":"Cappabianca","year":"2008"},{"key":"b6-jns142637","series-title":"Childs Nerv Syst","doi-asserted-by":"publisher","first-page":"796","DOI":"10.1007\/s00381-004-0933-3","article-title":"Endoscopic endonasal transsphenoidal surgery: procedure, endoscopic equipment and instrumentation","volume":"20","author":"Cappabianca","year":"2004"},{"key":"b7-jns142637","series-title":"Surg Neurol","doi-asserted-by":"publisher","first-page":"496","DOI":"10.1016\/j.surneu.2006.09.039","article-title":"Future of endoscopy in neurosurgery","volume":"67","author":"Cappabianca","year":"2007"},{"key":"b8-jns142637","series-title":"Surg Neurol","doi-asserted-by":"publisher","first-page":"342","DOI":"10.1016\/j.surneu.2006.09.040","article-title":"Endoscopic endonasal transsphenoidal surgery. 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