The use of endoscopes in transnasal surgery offers increased visualization. To minimize rhinological morbidity without restriction in manipulation, Reisch et al., introduced the mononostril [[transethmoidal paraseptal approach]].

The aim of the transethmoidal-paraseptal approach is to create sufficient space within the nasal cavity, without removal of nasal turbinates and septum. Therefore, as a first step, a partial [[ethmoidectomy]] is performed. The middle and superior turbinates are then lateralized into the ethmoidal space, allowing a wide sphenoidotomy with exposure of the central skull base.

This minimally invasive transethmoidal-paraseptal approach is a feasible alternative to traumatic transnasal concepts with middle turbinate and extended septal resection
((Reisch R, Briner HR, Hickmann AK. How I do it: the mononostril endonasal
transethmoidal-paraseptal approach. Acta Neurochir (Wien). 2017 Jan 18. doi:
10.1007/s00701-017-3075-6. [Epub ahead of print] PubMed PMID: 28097430.
)).