The transsphenoidal approach. A historical perspective.
Over the last century, the transsphenoidal approach has evolved into the first-line method of treatment for sellar as well as select groups of parasellar and suprasellar lesions. The journey to its current popularity has been marked by controversy and near abandonment in the late 1920s, followed by its renaissance in the late 1960s. Despite the profound skepticism with which this procedure was viewed, several visionary neurosurgeons persevered through its nadir in popularity, preserving this surgical corridor to the skull base. Advances in medical and surgical techniques, paralleling an improved understanding of pituitary pathophysiology, contributed to its resurgence. The transsphenoidal procedures now performed stem from an array of modifications and refinements accumulated through nearly 100 years of medical and surgical evolution. This era's critical innovations and neurosurgical personalities are the topic of this historical overview.
Kanter
Adam S
AS
Department of Neurological Surgery, University of Virginia Health System, Charlottesville, Virginia 22908, USA. ask9z@virginia.edu
Dumont
Aaron S
AS
Asthagiri
Ashok R
AR
Oskouian
Rod J
RJ
Jane
John A
JA
Laws
Edward R
ER
D001932:Brain Neoplasms / Q000473:pathology / Q000601:surgery; D035301:Cranial Fossa, Middle / Q000473:pathology / Q000601:surgery; D019299:Decompression, Surgical / Q000266:history / Q000379:methods; D049673:History, 20th Century; D006801:Humans; D002532:Intracranial Aneurysm / Q000473:pathology / Q000601:surgery; D009493:Neurosurgery / Q000266:history* / Q000379:methods*; D019635:Neurosurgical Procedures / Q000266:history* / Q000379:methods*; D010911:Pituitary Neoplasms / Q000473:pathology / Q000601:surgery*; D012658:Sella Turcica / Q000473:pathology / Q000601:surgery; D019291:Skull Base / Q000601:surgery*; D013100:Sphenoid Bone / Q000033:anatomy & histology / Q000601:surgery*