Surgery is the treatment of diseases of the human body through the path of trauma. In the development of surgery, there is a very important concept and idea that surgery should be performed by using the natural space and gap of the human body to enter the body as much as possible, thus minimizing the trauma suffered by the human body and thus maximizing the effect of the surgery itself. The pituitary tumor is located near the center of the skull, right in the middle of the skull base, and its projection outside the cranial cavity is exactly the pterygoid sinus. The nasal cavity and sinuses are spaces that are inherent to the body, and the transsphenoidal sinus approach makes good use of these spaces as a surgical approach, which is far less invasive than transcranial surgery. In the history of neurosurgery, the transcranial approach to pituitary tumor surgery was once prevalent because the complex facial cranial structure interfered with the understanding of the path to the pterygoid sinus and the pterygoid saddle at that time, resulting in the defects of the extracranial approach such as large facial impact, trauma, high infection rate and some sequelae; while the spherical skull structure was relatively simple, so transcranial surgery could be developed earlier. With the comprehensive development of science and technology, people have further understanding of the anatomy of the skull base, and the application of microscope, endoscope, sophisticated surgical instruments and image navigation technology makes it no longer difficult to reach the surgical site accurately and minimally invasive, thus greatly promoting the improvement of the efficacy of transsphenoidal approach. Although the anatomical location of pituitary tumors is complex and deep, the soft and fragile nature of most pituitary tumors makes it realistic and feasible to remove large tumors through small bony windows at the base of the saddle; in addition, the dural interposition of the pituitary gland makes the saddle septum a relatively safe barrier during transsphenoidal sinus surgery, thus greatly reducing the interference and impact of the surgical procedure on important intracranial neurovascular structures. In addition, the trans-pituitary sinus approach has become the main surgical approach for pituitary tumor surgery worldwide due to its advantages of less trauma, better brain protection, less pain and faster recovery.