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World Neurosurg. 2013 Feb;79(2):394-403. doi: 10.1016/j.wneu.2010.12.007. Epub 2011 Nov 11.

Sellar door: Harvey Cushing's entry into the pituitary gland, the unabridged Johns Hopkins experience 1896-1912.

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  • 1Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

Abstract

OBJECTIVE:

To review the original surgical records from the Johns Hopkins Hospital, and analyze the records of patients Cushing treated for pituitary disorders from 1896 to 1912.

METHODS:

Following IRB approval, and through the courtesy of the Alan Mason Chesney Archives, we reviewed the original surgical files from the Johns Hopkins Hospital. Patients presenting with pituitary-related symptoms, who underwent surgical treatment directed at the pituitary gland, were selected for further review.

RESULTS:

Thirty-seven patients who underwent surgical intervention for pituitary disorders were found. Of these patients, 12 were mentioned only briefly in Cushing's 1912 monograph, whereas 6 were not described at all. The remaining 19 were documented by Cushing in his 1912 monograph. Cushing used three main surgical approaches to the pituitary: transsphenoidal, transcranial, and the subfrontal "omega incision." There were 6 inpatient deaths. The mean time to last follow-up was 41.0 months. At follow-up, headache was the most common unresolved symptom.

CONCLUSION:

This review highlights Cushing's accomplishments in the surgical treatment of suspected pituitary pathology during his early career as a young attending at Johns Hopkins Hospital. It reveals new information about patients whom Cushing did not include in his publications detailing his surgical experience at the Johns Hopkins Hospital.

Copyright © 2013 Elsevier Inc. All rights reserved.

Comment in

PMID:
22079823
[PubMed - indexed for MEDLINE]
PMCID:
PMC3936577
Free PMC Article

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