General Considerations in the Surgical Treatment of Pituitary Tumors

  • Kalmon D. Post


In 1886, Marie1 suggested a relationship between acromegaly and pituitary tumors. By 1893, Caton and Paul2 reported an attempt at removal of a growth hormone (GH)-producing tumor via craniotomy and middle fossa approach. In 1905, Krause3 suggested an approach through the anterior cranial fossa, and in 1906, Sir Victor Horsley4 reported on 10 cases approached via the middle fossa. The techniques were crude and visibility poor; alternative routes were sought. The first extracranial transsphenoidal procedure was probably that by Schloffer5 in 1907, although Giordano6 had suggested a transsinus approach in 1897. Cushing7 began using a transsphenoidal approach in 1909, and thereafter performed over 200 cases via this route. Until then, the operation involved considerable dissection of the frontal sinus, nose, ethmoids, and sphenoids and was very disfiguring. In 1910, Halstead8 performed surgery through a transoronasal route with an incision through the mucosa above the upper teeth, utilizing the submucosal techniques of Kocher.9 In 1910, Oscar Hirsch10 did the first of 413 transsphenoidal procedures,1112 and introduced Harvey Cushing to the procedure. Cushing’s reputation attracted many patients, and within several years he had performed over 100 cases.13


Pituitary Adenoma Pituitary Tumor Transsphenoidal Surgery Pituitary Apoplexy Normal Gland 
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Copyright information

© Plenum Publishing Corporation 1980

Authors and Affiliations

  • Kalmon D. Post
    • 1
    • 2
  1. 1.Tufts University School of MedicineBostonUSA
  2. 2.Department of NeurosurgeryTufts-New England Medical Center HospitalBostonUSA

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