Pituitary Surgery; Innovators in Neurosurgery

Introduction: Pituitary Surgery has some of the most innovative techniques in our time. However, some of the advances needed in order to become a safe complex surgery are attributed to the initiative of the surgeons that created a lead in neurosurgery.

Methods: Literature Review.

Results: Since the nineteenth century, the importance of the endocrine system began to increase. Acromegaly was the condition that led to the first pituitary surgery. In 1893, Richard Caton and Frank T. Paul, members of the Liverpool Royal Infirmary, performed temporal fossa decompression on 33-year-old female with swelling face, hands and feet, a right.
It was in 1907 that Hermann Schloffer performed the first transsphenoidal approach, becoming popular in Europe and making its way to America via Harvey Cushing.
In 1902, Cushing’s first pituitary surgery was also decompressive intervention. 7 years later, in 1909, knowing Schloffer’s technique, Cushing modified it with a subfrontal approach and an “omega incision”, innovating the way in which the pituitary gland could be reached.
In The Pituitary Body and Its Disorders, published in 1912, Cushing described 52 patients that presented pituitary alterations, making him one of the most experienced surgeons on the pituitary gland.
It was in the same year when Walter Dandy performed his first pituitary surgery, starting one of the most recognizable careers in the pituitary surgery. Performing 287 pituitary surgeries, he became one of the most experienced surgeons in this field. Knowing the technological limitations of his time, he was aware of the better outcomes that the transcranial approach offered, a technique used for 7 decades in neurosurgery.

Conclusion : Surgical treatment for hypophysis alterations has been achieved under the leadership of some of the pioneers of neurosurgery. By being one of the most complex neuroanatomical regions to approach to, the call for innovative techniques was an imperative so that surgeons were able to perform better outcomes for patients.