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July 1961

Transantrosphenoidal Hypophysectomy

Arch Otolaryngol. 1961;74(1):2-8. doi:10.1001/archotol.1961.00740030005002

In pituitary surgery the transsphenoidal approach has been the subject of much discussion. In 1910, Oscar Hirsch 1 devised his transseptal technique, which was used in a large number of cases for operation of tumors in this region.2 The two chief objections raised to this procedure have been the risk of infection, and the poor exposure considered to be provided by the operative field. Dandy,3 for example, stated that the endonasal approach allows an exposure of the sella turcica no wider than a lead pencil. As a result of the advances in neurosurgery, the transcranial approach subsequently became the method of choice in treatment of pituitary tumors. It is of interest, however, to mention that Cushing4 considered the transsphenoidal route to be preferable under certain conditions.

When Luft, Olivecrona, and Sjögren 5,6 introduced hypophysectomy in the treatment of advanced mammary cancer, Olivecrona chose the transcranial approach, which has later been

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