Endoscopic Anatomy Along the Transnasal Approach to the Pituitary Gland and the Surrounding Structures

Abstract

“The nasal route is impracticable and can be never otherwise”, Dandy, 1945 [2]. This assumption of one of the greatest neurosurgeons of the 20^th century proved to be wrong. The idea of reaching the pituitary along the preformed route through the nose and the sphenoid sinus goes back to Davide Giordano’s [4] theoretical considerations in 1894. Schloffer [13] first practically tried to access the pituitary by reflecting the nose and removing most of what is inside it, i.e. the nasal septum, the turbinates and the ethmoid. Kanavel [8] only reflected the lower half of the nose and thus spared the ethmoid, while Halstead [5] used a sublabial approach. With Hirsch’s [6, 7] work the transnasal approach made its first breakthrough in 1909.