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, at that time, the complex facial cranial structure interfered with the understanding of the pathway to the pterygoid sinus and the pterygoid saddle, resulting in a large impact on the face, trauma, high infection rate, and some sequelae of the extracranial approach. With the comprehensive development of science and technology, people have further understanding of the anatomical structure 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 efficacy of transcranial sinus surgery. The use of the microscope, sophisticated surgical instruments and imaging navigation technology has made it less difficult to reach the surgical site precisely and minimally invasively. Although pituitary tumors have a complex and deep anatomical location, the soft and fragile nature of most pituitary tumor pathology makes it feasible to remove large tumors through small bony windows in the saddle base. In addition, the pituitary gland is an interdural organ, which makes the saddle septum a relatively safe barrier during transsphenoidal surgery, thus greatly reducing the interference and impact of the surgical procedure on important intracranial neurovascular structures. In summary, transsphenoidal sinus surgery 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, etc. Currently, more than 95% of patients with pituitary tumors and other intra-saddle diseases undergo transsphenoidal sinus surgery in more technologically advanced countries and regions.