The various operations designed for the removal of tumors of the pituitary gland in which entrance is made through the nose have all passed through the upper part of the nasal cavity.
After an extensive study of the anatomy and repeated operations on the cadaver, I have worked out the details of an infranasal procedure and herewith submit the details of the technic.
In general, two routes are proposed, the intracranial and the extracranial or trans-sphenoidal. The former has been suggested by Caton and Paul, Krause, Kiliani and Caselli, and put into use by Horsley and McArthur. In the main, however, surgeons are inclined to view that approach with disfavor owing to the difficulties and dangers incident thereto, and Braun is the only one of the recent contributors who maintains that the route is practicable. Certainly, a study of the anatomy and the reports of the pathology, present in the