The extended endoscopic endonasal approach is a promising minimally invasive alternative for selected cases with sellar, parasellar or clivus lesions. As techniques and technology advance, this approach may become the procedure of choice for most lesions and should be considered an option in the management of the patients with these complex pathologies by skull base surgeons.

Objectives: Pituitary adenomas are the most common disorders of the sellar region seen in neurosurgical practice .Surgical excision through the transsphenoidal route is recognized as the best option to treat these lesions and the endonasal endoscopic approach (EEA) has been introduced in many centers. This article analyzes results using this technique. Material and methods: EEA was used to operate on 278 patients at the Neurosurgery Department of "Hermanos Ameijeiras" Hospital in Havana from January 2005 to December of 2011. Results: Two hundred thirty eight patients had pituitary macroadenomas and forty had microadenomas. Ninety two were functioning adenomas (52 GH, 34 ACTH and 6 PRL) and one hundred eighty six were non-functioning. Gross total resection was achieved in 92.4% and subtotal resections in 7.5%. Complications occurred in 25 patients; diabetes insipidus was permanent in 11 cases. Conclusion: Because of the remarkable results for treating pituitary lesions, EEA has become a valuable technique in neurosurgical practice and in many centres has become the first option to consider in pituitary surgery.