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Endoscopic One-Nostril Trans-Septal Trans-Sphenoidal Approach for Pitutary Tumors: Back to the Past—A Multi-Center Preliminary Experience and Literature Review

by Denis Aiudi, Alessio Iacoangeli, Andrea Mattioli, Simone Russo, Massimo Balbi, Stefano Vecchioni, Michele Luzi, Roberto Trignani, Alberto Califano, Ruggero Antonini, Mario Chiapponi, Fabio Greco, Fabrizio Salvinelli, Kenan Arnautovic, Maurizio Iacoangeli, and Maurizio Gladi

Posted: December 9, 2025
Server: Preprints.org
DOI: 10.20944/preprints202512.0583.v1

This study presents the Endoscopic One Nostril Transseptal Transsphenoidal Approach (EONOTTA) as a minimally invasive surgical technique for se-lected cases of pituitary macroadenomas. Derived from the classic endoscopic endonasal approach, EONOTTA allows excellent exposure of the sellar re-gion while preserving nasal mucosa and olfactory function. The technique offers comparable disease control to standard endoscopic endonasal ap-proaches, with reduced sinonasal morbidity and postoperative discomfort. Despite limitations such as retrospective design and small sample size, findings support EONOTTA as a safe, efficient alternative for non-extended pituitary tumors requiring limited surgical exposure.

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