1. Development of Pituitary Surgery: The Chicago Contributions
James L. Stone, MD, Guido Meglio, MD, Edward R. Laws, MD 
Journal of the American College of Surgeons 
Volume 201, Issue 5, Pages (November 2005)
DOI: /j.jamcollsurg
Copyright © 2005 American College of Surgeons Terms and Conditions

2. Figure 1
Christian Fenger in the 1880s. (From: the Center for the History of Neuroscience, Department of Neurological Surgery, University of Illinois, Chicago, with permission.)
Journal of the American College of Surgeons  , DOI: ( /j.jamcollsurg )
Copyright © 2005 American College of Surgeons Terms and Conditions

3. Figure 2
Lateral skull x-ray obtained by Victor Horsley on a Chicago boy referred to London for surgery in Enlarged sella turcica marked +. (From: Church A. Pituitary tumor in its surgical relations. JAMA 1909;53:97–105, with permission.)
Journal of the American College of Surgeons  , DOI: ( /j.jamcollsurg )
Copyright © 2005 American College of Surgeons Terms and Conditions

4. Figure 3
Allen B Kanavel (1874–1938). (From: the Center for the History of Neuroscience, Department of Neurological Surgery, University of Illinois, Chicago, with permission.)
Journal of the American College of Surgeons  , DOI: ( /j.jamcollsurg )
Copyright © 2005 American College of Surgeons Terms and Conditions

5. Figure 4
(A) Lateral skull x-ray on the patient referred to Kanavel in June 1909, which led to development of the infranasal approach. Arrows indicate enlarged sella turcica. (From: Kanavel AB, Grinker J. Removal of tumors of the pituitary body with a suggestion as to a two-step route, and a report of a case with a malignant tumor operated upon with a primary recovery. Surg Gynecol Obstet 1910;10:414–418, with permission.) (B,C) Kanavel’s published report on the infranasal method, November (From: Kanavel AB. The removal of tumors of the pituitary body by an infranasal route. A proposed operation with a description of the technic. JAMA 1909;53:1704–1707, with permission.)
Journal of the American College of Surgeons  , DOI: ( /j.jamcollsurg )
Copyright © 2005 American College of Surgeons Terms and Conditions

6. Figure 5
Albert E Halstead (1868–1926). (From: the Center for the History of Neuroscience, Department of Neurological Surgery, University of Illinois, Chicago, with permission.)
Journal of the American College of Surgeons  , DOI: ( /j.jamcollsurg )
Copyright © 2005 American College of Surgeons Terms and Conditions

7. Figure 6
(A) Halstead’s sublabial intraoral incision for the infranasal trans-sphenoidal approach (July 1909). (B) Patient shown 2 months after surgery. (From: Halstead AE. Remarks on the operative treatment of tumors of the hypophysis with the report of two cases operated on by an oro-nasal method. Surg Gynecol Obstet; 10:494–502, and Trans Am Surg Soc 1910;28:73–93.) (C) Acidophilic pituitary adenoma from Halstead’s second patient. Pathology report by Dean Lewis. (From: Lewis DD, Kanavel AB. Surgery of the hypophysis (pituitary gland). In: Keen WW, ed. Surgery, its principles and practice. Vol 6. Philadelphia: WB Saunders; 1916:269–316, with permission.)
Journal of the American College of Surgeons  , DOI: ( /j.jamcollsurg )
Copyright © 2005 American College of Surgeons Terms and Conditions

8. Figure 7
Dean D Lewis (1874–1941). (From: the Center for the History of Neuroscience, Department of Neurological Surgery, University of Illinois, Chicago, with permission.)
Journal of the American College of Surgeons  , DOI: ( /j.jamcollsurg )
Copyright © 2005 American College of Surgeons Terms and Conditions

9. Figure 8
(A, B) Kanavel’s trans-sphenoidal operative approach with patient sitting and skin incision placed around the base of the nose. The sellar floor is entered with a bone punch. (From: Kanavel AB, Jackson H. Cysts of the hypophysis. Surg Gynecol Obstet 1918;26:61–70, with permission.) (C) Nasal specula used by Kanavel for trans-sphenoidal surgery (photograph courtesy of Dr Nicholas Wetzel).
Journal of the American College of Surgeons  , DOI: ( /j.jamcollsurg )
Copyright © 2005 American College of Surgeons Terms and Conditions

10. Figure 9
Lewis L McArthur (1858–1934). (From: the Center for the History of Neuroscience, Department of Neurological Surgery, University of Illinois, Chicago, with permission.)
Journal of the American College of Surgeons  , DOI: ( /j.jamcollsurg )
Copyright © 2005 American College of Surgeons Terms and Conditions

11. Figure 10
Lateral skull x-ray from the patient with a pituitary tumor operated on by McArthur in March Enlarged sella turcica marked +. (From: Church A. Pituitary tumor in its surgical relations. JAMA 1909;53:97–105, with permission.)
Journal of the American College of Surgeons  , DOI: ( /j.jamcollsurg )
Copyright © 2005 American College of Surgeons Terms and Conditions

12. Figure 11
(A) LL McArthur’s extradural approach to the pituitary as reported in (B) Note the eyebrow incision onto the forehead, and (C) tablespoon used to depress the orbital contents. (D) Photograph of a patient. (From: McArthur LL. An aseptic surgical access to the pituitary body and its neighborhood. JAMA 1912;58:2009–2011, with permission.)
Journal of the American College of Surgeons  , DOI: ( /j.jamcollsurg )
Copyright © 2005 American College of Surgeons Terms and Conditions

13. Figure 12
(A) LL McArthur’s 1918 transcranial fronto-orbital approach illustrating removal of the supraorbital ridge with the bone flap, depression of the periorbita, and piecemeal removal of left orbital roof (B) extradural approach to the anterior clinoid, and (C) opening of the dura exposing the optic nerve, A, and pituitary (+). (From: McArthur LL. Tumor of the pituitary gland; technic of operative approach. Surg Clin Chicago 1918;2:691–699, with permission.)
Journal of the American College of Surgeons  , DOI: ( /j.jamcollsurg )
Copyright © 2005 American College of Surgeons Terms and Conditions

14. Figure 13
Harvey Cushing’s patient with a large pituitary adenoma who underwent bilateral craniotomies. Note the McArthur incision on patient’s right and Heuer incision on the patient’s left. (From: Cushing H. Intracranial tumours. Notes upon a series of two-thousand verified cases with surgical-mortality percentages pertaining thereto. Springfield, IL: Charles C Thomas; 1932:69–79, with permission.)
Journal of the American College of Surgeons  , DOI: ( /j.jamcollsurg )
Copyright © 2005 American College of Surgeons Terms and Conditions