The Sphenoidal Sinus

The treatment of tumours of the hypophysis has for long been surgical and during the last ten years hypophysectomy has been introduced as a method of dealing with métastases from carcinoma of the breast and for diabetes mellitus associated with angiopathy (LUFT, OLIVEGRONA and SJÖGREN 1952, 1953). The operation is performed by the transcranial exposure of the hypophysis. Various types of transsphenoid operations have come into use on an increasing scale. ESGHER and R O T H (1957) and GISSELSSON (1957) have employed the transethmosphenoid route by the Chiari method while HAMBERGER et coll. (1961) have introduced the transantrosphenoid method. There are numerous anatomical variations of the sphenoidal sinus. Varia­ tions in its size will affect the boundaries of the hypophysis, i. e, the anterior wall and the floor of the sella turcica will possess a varying thickness and degree of protrusion into the sphenoidal sinus. The lateral extensions of the anterior wall, and thus the distance between the carotid arteries and the cavernous sinus, may vary within a fairly wide range. Bony septa frequently occur in the sphenoidal sinus; their position is inconstant and they may sometimes impede the surgical approach. The topographic anatomy has a decisive bearing on the operability and surgical approach. Preoperative roentgenologic analysis therefore plays an