Transsphenoidal Operation for Tumors of the Pituitary Gland

THE FIRST SURGERY on the hypophysis by the transsphenoidal approach was performed by Cushing,¹Hirsch,^2,3Chiari⁴60 years ago. These were soon discontinued because of infections, high mortality, and lack of radicality of surgery due to insufficient pituitary hormone replacement. Restriction of infections by the use of antibiotics, better surgical facilities (surgical microscope), and new findings in endocrinology to replace the totally removed hypophysis are mainly responsible for the impetus of this approach in rhinological surgery during the last 15 years. In some rhinological departments, new centers were developed recently which deal especially with this type of surgery. The purpose of this manuscript is to elucidate our view concerning the indications of rhinological hypophyseal operations and to report the results so obtained. The treatment of tumors of the hypophysis depends on their course, symptoms and therapeutic possibilities. There are cases in which the growth of an adenoma