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September 1967

Transseptal Transsphenoidal Hypophysectomy: A New Approach

Author Affiliations

San Francisco
From the Division of Otolaryngology, University of California, San Francisco Medical Center, San Francisco.

Arch Otolaryngol. 1967;86(3):252-255. doi:10.1001/archotol.1967.00760050254003

THE PITUITARY FOSSA, because of its intimate anatomical relationship to the sphenoid sinus, lends itself well to a transsphenoidal surgical approach. The sphenoid sinus, in turn, has been reached by various transnasal and transsinus routes. The purpose of this article is to describe an operative technique for hypophysectomy which we feel is superior to previously described rhinologic approaches. The essentials of this operation consist of: (1) exposing the posterior septal area through a lateral rhinotomy, creating wide access to this area by fracturing the nasal wall laterally into a maxillary sinus fenestra; (2) entering the sphenoid through a short, midline, transseptal route; and (3) utilizing the wide field of exposure and the operating microscope for total hypophysectomy.

The rhinologic approach to the pituitary fossa is desirable for the following problems: (1) biopsy or excision of certain pituitary tumors; (2) ablation of the pituitary gland for endocrine responsive metastatic breast cancer

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