Craniopharyngioma historical perspective

Function of the pituitary gland were formulated in the 4th century BC by Hippocrates. Harvey Cushing (1869–1939), has had a major impact in the understanding of pituitary function and surgery but he was not the first surgeon to attempt pituitary surgery; this honor goes in 1889 to Sir Victor Horsley. Hermann Schloffer (1868–1937), an Austrian surgeon, performed the first transfacial transsphenoidal approach in 1907. In the 1960s, transsphenoidal surgery underwent a revival and has been universally accepted.

• Primitive concepts of the function of the pituitary gland were formulated in the 4th century BC by Hippocrates of Cos (460–370 BC).^[1]
• Joseph Lieutaud (1703–1780), a French physician and anatomist, named the pituitary stalk by proposing the term “Tige Pituitaire” .
• In 1886, Pierre Marie (1853–1940), a French physician, demonstrated the association between acromegaly and pituitary tumors.
• In 1840, von Mohr described the rapid development of obesity in a case of a pituitary tumor.
• Zenker in 1857 was the first to identify masses of cells resembling squamous epithelium along the pars tuberalis and pars distalis of the pituitary.^[2]
• In 1932, squamous epithelial cells were detected in the pituitary glands of childhood populations.^[2]
• in 1932 the name “craniopharyngioma” was introduced by Cushing.^[2]
• The first pituitary surgery was performed by Horsley in 1889 using a transfrontal approach.^[3]

• Transcranial approaches to the pituitary gland in the late 1800s and early 1900s resulted in high mortality rate.^[4]
• Schloffer suggested the use of a transsphenoidal route as a safer, alternative approach to the sella turcica.
• First successful removal of a pituitary tumor via the transsphenoidal approach in 1906.
• A. E. Halstead’s described in 1910 the sublabial gingival incision for the initial stage of exposure.^[5]
• Norman Dott, in 1923, continued to use the transsphenoidal procedure while others pursued transcranial approaches.
• Jules Hardy, who used intraoperative fluoroscopy in transsphenoidal approach to reach pituitary.^[4][5]

• The first endosopic surgery was performed by Hirschman, an otolaryngologist, in 1901.^[1]
• In 1957, Basil Hirschowitz, an American gastroenterologist, demonstrated the use of a fiberoptic endoscope.^[3]
• In 1965, Karl Storz revolutionized the use of fiberoptics by using an external cold light source coupled with the rod lens optical system.
• In pituitary transsphenoidal surgery, Guiot was the first, in 1961, to use the endoscope. ^[1]
• The endoscope was used in conjunction with transsphenoidal microsurgery, notably by Apuzzo, Bushe and Halves in the late 1970s.
• Endoscopic transsphenoidal procedure was introduced in the early 1990s.
• In 1992, Jankowski was the first to report the use of the pure endonasal endoscopic procedure for pituitary adenomas.^[1]

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