Objective:To improve the surgical efficiency of neuroendoscopic pituitary adenoma resection through a single nasal septal pterygoid sinus approach by improving the surgical technique and instruments. METHODS:A neuroendoscopic transseptal pterygoid approach was used to remove pituitary adenomas in 288 cases without searching for the opening of the pterygoid sinus, and the mucosa of the nasal septum was incised longitudinally with monopolar electrocoagulation using the middle turbinate as the anatomical landmark. At the end of the operation, the nasal mucosa was repositioned without the need for refilling the nasal cavity. Results:The average operation time of the patients was 70 min, and the shortest operation time was only 30 min. There was no cerebrospinal fluid leakage during the operation, and they were discharged from the hospital 3-5 d after the operation with satisfactory results. Conclusion:Neuroendoscopic pituitary adenoma resection via single nasal septal pterygoid sinus approach has short operation and hospital stay, less bleeding, good protection of mucosal structures in the nasal cavity, less postoperative complications, and can achieve the effect of no postoperative surgical traces, and the improvement and correct application of surgical instruments are the keys to improve the efficiency of the operation.