A, The sublabial approach is directed under the lip and submucosally along the side of the nasal septum to the face of the sphenoid. The inset shows the site of the gingivobuccal incision and the direction of insertion of the speculum under the lip to reach the nasal cavity. B, The transseptal approach is directed through a small incision in the mucocutaneous junction along the side of the columella and submucosally along the septum to the sphenoid face. C, The Rhoton endonasal transsphenoidal speculum has been inserted along the route of the endonasal transsphenoidal approach directed through one nostril, between the conchae laterally and the nasal septum medially. D, The broken line shows the area where the posterior septum is separated from the face of the sphenoid sinus. (Images courtesy of AL Rhoton, Jr.)