The Paranasal Approach to Intrasellar Tumours

Abstract

BEFORE entering upon the subject of my lecture I should like to express my best thanks to the Semon Lectureship Board for the honour of their invitation to me. The fact that once again this honour has been bestowed on a foreign Rhinologist instead of on one of the many eminent British confreres is a new proof how faithfully the Selection Committee follows the ideas of Sir Felix Semon, who was a very successful promoter of international scientific interchange. We are convinced that only a common devotion here to medical science can effectively bind people. To further this aim I have tried to pay my contribution by this study. Moreover, I should like to pay my respects to the holder of the Lectureship-to the University of London. There are special relations between this institution and our country, as among one of the founders and first senators there was a Swiss, whose name is not quite forgotten, Peter Marc Roget, the editor of the Thesaurus of English Words and Phrases. I have great pleasure, being at the present time Dean of the medical faculty, in conveying the greetings of the Alma Mater Turicensis. Motto : ". .. there is only one thing that can effectively bind people and that is a common devotion."-Consecratio Medici, by Harvey Cushing, to whose memory this paper is dedicated.

Hypophysectomy as a Rhinological Procedure

“…The classical transseptal approach to the pituitary of Harvey Cushing and the trans¬ ethmoidal route advocated by Nager 13 paved the way to other rhinological routes, includ¬ ing the nasal ostéoplastie.…”

“…(13) The parietal and investing durai layers are now incised by means of a cutting diathermy in the midline, stopping short of the anterior communicating sinus, and a cross-incision is similarly made of about the same size. The 4 flaps can now be lifted aside.…”

The Semon Lectures and the foundation of modern ENT

“…Also around this time, Nager (1939) commented on the disagreement between the neurosurgeons and rhinologists over the best way to resect pituitary tumours, and whether to favour either a trans-frontal or trans-sphenoidal approach. 14…”

“…Also around this time, Nager (1939) commented on the disagreement between the neurosurgeons and rhinologists over the best way to resect pituitary tumours, and whether to favour either a trans-frontal or trans-sphenoidal approach. 14 After World War II, the impetus for social change that eventually culminated in the establishment of the National Health Service (NHS) by Aneurin Bevan in 1948 was years in the making. The Emergency Medical Service, which was set up in 1938, centralised the running of hospitals in the anticipation of a great number of casualties from World War II.…”

The Value of a Collaborative Neurosurgical and Rhinological Approach to Microsurgery of Tumors in the Chiasm-Sella Turcica Region

“…The role of the two possible routes of access to the sella turcica region, i. e., the intracranial and the extracranial approaches, is well reflected in the history of pituitary surgery. Ever since the pituitary was first exposed by Fedor Krause in 1905, both neurosurgeons (Krause 1905(Krause , 1908(Krause , 1911Cushing 1912;Frazier 1913Frazier , 1916Frazier , 1928Dandy 1922Dandy , 1932Olivecrona 1941Olivecrona , 1953Grant 1948;Tönnis 1952;Krayenbiihl 1958;Guiot 1958;Guiot and Thibaut 1955;Ray and Patterson jr. 1962;Svien et al 1965) and rhinologists (Schloffer 1907;Hirsch 1910Hirsch , 1930Hirsch , 1952Hirsch , 1956Chiari 1912;Kahler 1917;Nager and Henschen 1919;Nager 1929Nager , 1936Nager , 1940Hamberger et al 1959Hamberger et al , 1961 attempted to find optimum surgical techniques, with preference alternately given to one or the other approach particularly by the neurosurgeons. While Fedor Krause was the first to use the transfrontal approach, Schlofter first opted for the trans-sphenoidal route in 1907.…”