Since the 1960’s, the transsphenoidal approach to the hypophyseal adenomas has been the technique used most frequently. Sublabial transseptal technique was considered a classical approach for a long time. On the base of their experience with 24 patients, the authors have described the direct transnasal miniinvasive approach – still not published in details in our country. The main goal of the report was to describe the methodology of an operation and to compare it with classical sublabial as well as endoscopic techniques. A prospective analysis was carried out in a set of patients (14 women, 10 men), mean age 49.9 years ranging between 21 and 80 years. Radical removal of a tumor was reached in 21 (87.5%) patients, permanent substitutional hormonal therapy after an intervention was initiated in 3 patients. The direct transnasal approach brings a lesser traumatization of the nasal cavity, shortens the period of discomfort due to nasal tamponade, and eliminates the insensitivity of upper incisors. In comparison with endoscopic technique, the tumor resection and bleeding stasis are made easier and safer.

        Key words: transsphenoidal surgical approach, hypophyseal adenoma, selective adenomectomy, miniinvasive surgery, operation technique, direct transnasal transsphenoidal approach.