Toader Corneliu, Popa Andrei-Adrian, Covache-Busuioc Razvan-Adrian, Bratu Bogdan-Gabriel, Ciurea Alexandru Vlad
Department of Neurosurgery, National Institute of Neurology and Neurovascular Diseases, 077160 Bucharest, Romania.
Department of Neurosurgery "Carol Davila", University of Medicine and Pharmacy, 020021 Bucharest, Romania.
Brain Sci. 2023 Oct 8;13(10):1431. doi: 10.3390/brainsci13101431.
The pituitary gland, a puzzling medical subject up until the 20th century, had its early pathologies first documented in the 19th century by Pierre Marie and Hutchinson, where the gland's meaningful study was hindered by its hard-to-reach location. This paper revisits the pioneering work of Romanian doctors such as Gheorghe Marinescu, Nicolae Paulescu, and Grigore T. Popa in surgical techniques targeting the pituitary gland. Marinescu's 1892 experiment, albeit unsuccessful, laid the groundwork for future research in this area. Before Paulescu, surgical attempts could be classified into three types: oral, cranial, and sphenopalatine fossa approaches-all of which were notably dangerous and often resulted in fatal bleeding. Paulescu was the first to successfully and safely perform a complete in vivo hypophysectomy, opting for an innovative subtemporal method. He also conducted extensive research over four years to identify the gland's essential functions. Later, a 1938 study by Popa and Harris demonstrated a temporal approach to the hypothalamo-hypophysial region in a rabbit. These groundbreaking contributions significantly influenced the trajectory of pituitary gland surgery.
垂体 gland,在 20 世纪之前一直是一个令人困惑的医学课题,其早期病理学最早由皮埃尔·玛丽和哈钦森在 19 世纪记录下来,当时由于其难以触及的位置,对该 gland 的有意义研究受到了阻碍。本文回顾了罗马尼亚医生如格奥尔基·马林内斯库、尼古拉·保莱斯科和格里戈尔·T·波帕在针对垂体 gland 的手术技术方面的开创性工作。马林内斯库 1892 年的实验尽管没有成功,但为该领域的未来研究奠定了基础。在保莱斯科之前,手术尝试可分为三种类型:经口、经颅和蝶腭窝入路——所有这些方法都非常危险,常常导致致命出血。保莱斯科是第一个成功且安全地进行完整的体内垂体切除术的人,他选择了一种创新的颞下入路方法。他还进行了长达四年的广泛研究,以确定该 gland 的基本功能。后来,波帕和哈里斯 1938 年的一项研究展示了在兔子身上对下丘脑 - 垂体区域采用的颞部入路。这些开创性的贡献显著影响了垂体 gland 手术的发展轨迹。