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Schoem SR, Khan A, Wilson WR, et al. Minimizing Upper Lip and Incisor Teeth Paresthesias in Approaches to Transsphenoidal Surgery. Otolaryngol Head Neck Surg. 1997;116(6):656-661doi: 10.1016/S0194-5998(97)70244-4.
Schoem, S. R., Khan, A., Wilson, W. R., & Laws, E. R. (1997). Minimizing Upper Lip and Incisor Teeth Paresthesias in Approaches to Transsphenoidal Surgery. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 116(6), 656-661. https://doi.org/10.1016/S0194-5998(97)70244-4
Schoem, Scott R, et al. "Minimizing Upper Lip and Incisor Teeth Paresthesias in Approaches to Transsphenoidal Surgery." Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery vol. 116,6 (1997): 656-661. doi: https://doi.org/10.1016/S0194-5998(97)70244-4
Schoem SR, Khan A, Wilson WR, Laws ER. Minimizing Upper Lip and Incisor Teeth Paresthesias in Approaches to Transsphenoidal Surgery. Otolaryngol Head Neck Surg. 1997 Jun;116(6):656-661. doi: 10.1016/S0194-5998(97)70244-4. PMID: 29389272.
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Otolaryngol Head Neck Surg. 1997 Jun;116(6):656-661. doi: 10.1016/S0194-5998(97)70244-4.

Minimizing Upper Lip and Incisor Teeth Paresthesias in Approaches to Transsphenoidal Surgery.

Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery

Scott R Schoem, Anjum Khan, William R Wilson, Edward R Laws

Affiliations

  1. 1 Uniformed Services University of the Health Sciences (Dr. Schoem), Bethesda, Maryland, Washington, D.C.
  2. 2 George Washington University Medical Center, Bethesda, Maryland, Washington, D.C.

PMID: 29389272 DOI: 10.1016/S0194-5998(97)70244-4

Abstract

Currently popular transsphenoidal approaches to the pituitary include sublabial, external rhinoplasty, alotomy, and transnasal techniques. The conventional sublabial approach remains the workhorse method despite postoperative lip edema, potential difficulty for denture wearers, and troublesome persistent upper lip and incisor teeth numbness. We traced the courses of the nasopalatine, infraorbital, and anterior superior alveolar nerves in 41 cadaveric half-head dissections to determine the exact contribution to upper lip and incisor teeth innervation. We then conducted a retrospective patient survey of 25 sublabial, 28 external rhinoplasty, 23 alotomy, and 12 transnasal approaches to the hypophysis to assess the incidence of upper lip and incisor teeth paresthesias lasting longer than 1 month. We conclude that rhinoplastic techniques are superior to the sublabial approach in limiting upper lip and incisor teeth numbness without compromising neurosurgical exposure for hypophysectomy.

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