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pituitary surgery I will give you a brief overview of the history of pituitary surgery. Sir Victor Horsley was the first surgeon to operate on a pituitary adenoma
in testicular cancer to replace testosterone; used in pituitary malfunction to aid in growth and development; and used after cancer surgery to regain muscle tissue.
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anabolic steroids when they reach the appropriate age for puberty. Anabolics given for four to six months in the proper dosing schedule cause the growth spurt and
University of Pittsburgh. (2006) What is the Pituitary Gland? Department of Neurological Surgery.
Submitted by hugojjj on May 22, 2007
Category: Science
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I will give you a brief overview of the history of pituitary surgery.
Sir Victor Horsley was the first surgeon to operate on a pituitary adenoma 1889
This is his drawing of the middle fossa approach that was used.Later he also used a subfrontal approach.His mortality rate was 20 % which should be compared to the results of other contemporary surgeons with mortality between 50-80 %
The first successful transsphenoidal removal of a pituitary adenoma was performed a hundred years ago by Herman Schloffer an Austrian ENT surgeon using an extended lateral rhinotomy incision
The transsphenoidal approach as we know it today was initiated by Harvey Cushing .He used an incision under the upper lip get access to nasal septum
The sella was reached through tunnel under the mucosa of the septum
He performed 231 procedures with a mortality of 5,6 % .He returned to the trans cranial approach in spite of this comparatively low mortality figure.
He believed that the transcranial approach enabled a better decompression of the optic apparatus.Due to the enormous influence of Cushing on the neurosurgical community the transsphenoidal approach was more or less abandoned for the transcranial route
A revival of the transsphenoidal approach came with the introduction of fluoroscopy and the operating microscope in the sixties which gave effective light in the deeply situated surgical field
Selective adenomectomy was a milestone . Jules Hardy showed that it was possible to selectively remove a hormone-producing microadenoma
Ninety years after Schloffer a pure endoscopic procedure was into pituitary surgery
Relieve mass effect aim at decompression of nervous structures
Normalize hypersecretion is only possible by the transsphenoidal approach
Later treatment is based on the examination of the surgical specimen
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