We retrospectively analysed the medical records of over 1,000 patients with pituitary lesions treated by three types of transseptal-transsphenoidal approach (TSA), including the sublabial, the external rhinoplasty, and the collumellar flap technique at Seoul National University Hopital from 1977 to 1995. We investigated the rhinologic complications according to three types of TSA. Four hundred fifiy nine patients were included in this study with a mean follow-up of 6 months. There were no differences in postoperative subjective complaints including nasal respiration and olfaction among the three approaches. Rhinologic complications including nasal respiration, olfaction, dryness, crusting of the nose and upper lip paresthesia, occurred in 39.9% of the patients. Dryness and crusting of the nose was the most frequent problem irrespective of the approaches. The sublabal approach made upper lip paresthesia more frequently than three approaches. In our experience, the columella flap technique was fastest and easiest one, and its cosmetic results were acceptable for the patients. In conclusion we consider that careful operative technique rather than the approach per se offers the best assurance of successful operation and minimal rhinological complications.