Surgical Technique for Cryogenic Hypophysectomy

OUR PURPOSE is to present a technique of cryogenic hypophysectomy which has proven to be easier for the surgeon and safer for the patient than some other methods, while still achieving the desired result: ablation of pituitary function. The technique is transeptal-transphenoidal hypophysectomy using a cryogenic probe.

Techniques for Hypophysectomy  The most common approach to the pituitary gland has been by anterior craniotomy. Hirsch¹ and Cushing² were the first to approach the gland by the transeptal method. They attempted to remove pituitary tumors.In 1952 Olivecronia⁴ first described the treatment of metastatic breast cancer by hypophysectomy. He advocated a transcranial approach. The extensive series by Ray and his associates^4-6 has provided much of the present knowledge concerning the relevant physiology of hypophyseal surgery.Recent improvements in surgical instruments and techniques, by both neurosurgeons and otorhinolaryngologists, have brought about a reassessment of hypophysectomy via extracranial approaches.Besides