Journal article
Hajek and Hirsch: Otolaryngology Pioneers of Endonasal Transsphenoidal Pituitary Surgery
The Laryngoscope, Vol.133(4), pp.807-813
11/24/2022
DOI: 10.1002/lary.30496
PMCID: PMC10023270
PMID: 36420787
Appears in UI Libraries Support Open Access
Abstract
OBJECTIVE To evaluate the historical descriptive origins of the extracranial transnasal transsphenoidal route to the sphenoid sinus and sella turcica focusing on the works of two otolaryngologists: Markus Hajek (1861-1941) and Oskar Hirsch (1877-1965). DATA SOURCESA collection of primary references of author publications, and contemporary references and textbooks. REVIEW METHODS Primary references were reviewed with specific focus on surgical routes to the sphenoid sinus and sella turcica. Chronology was cross-referenced with contemporary publications by contemporaries. Translations from German were conducted by author AM when necessary. RESULTS Markus Hajek elegantly described the surgical approach to the posterior ethmoids and sphenoid sinus in 1904 using a transnasal route. Building on this foundation, Oskar Hirsch described the fully extracranial endonasal transethmoid transsphenoidal approach in 1909. He was first to describe surgical entrance to the sella using this exclusively unilateral endonasal route, which he demonstrated on a cadaver. He reports performing this procedure on a live patient in April, 1910, under local anesthesia in stages over 5 weeks. For better exposure, Hirsch consolidated his method with Killian's submucosal window resection of the posterior nasal septum allowing for bilateral access to the sphenoid sinus and sella, and completed a single stage procedure on a patient in June 1910. CONCLUSION Oskar Hirsch was the first to describe and perform a stepwise surgical approach to the sella using an exclusively extracranial, endonasal, transethmoid, and transsphenoidal approach. He built upon his mentor Markus Hajek's approaches to the posterior ethmoid cells and sphenoid sinus. LEVEL OF EVIDENCEN/A: Background information, synthesis from multiple sources emphasizing factual information Laryngoscope, 2022.
Details
- Title: Subtitle
- Hajek and Hirsch: Otolaryngology Pioneers of Endonasal Transsphenoidal Pituitary Surgery
- Creators
- Nir Ben-Shlomo - University of IowaAlbert Mudry - Stanford UniversityJames Naples - Beth Israel Deaconess Medical CenterJarrett Walsh - University of IowaTimothy R Smith - Brigham and Women's HospitalEdward R Laws - Brigham and Women's HospitalC Eduardo Corrales - Brigham and Women's Hospital
- Resource Type
- Journal article
- Publication Details
- The Laryngoscope, Vol.133(4), pp.807-813
- DOI
- 10.1002/lary.30496
- PMID
- 36420787
- PMCID
- PMC10023270
- NLM abbreviation
- Laryngoscope
- eISSN
- 1531-4995
- Publisher
- Wiley
- Grant note
- DOI: 10.13039/100000055, name: National Institute on Deafness and Other Communication Disorders, award: 5T32DC000040
- Language
- English
- Electronic publication date
- 11/24/2022
- Academic Unit
- Otolaryngology
- Record Identifier
- 9984323338102771
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