{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T11:14:37Z","timestamp":1793272477037,"version":"4.5.0"},"reference-count":29,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2022,11,24]],"date-time":"2022-11-24T00:00:00Z","timestamp":1669248000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000055","name":"National Institute on Deafness and Other Communication Disorders","doi-asserted-by":"publisher","award":["5T32DC000040"],"award-info":[{"award-number":["5T32DC000040"]}],"id":[{"id":"10.13039\/100000055","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the historical descriptive origins of the extracranial transnasal transsphenoidal route to the sphenoid sinus and sella turcica focusing on the works of two otolaryngologists: Markus Hajek (1861\u20131941) and Oskar Hirsch (1877\u20131965).<\/jats:p><\/jats:sec><jats:sec><jats:title>Data Sources<\/jats:title><jats:p>A collection of primary references of author publications, and contemporary references and textbooks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Review Methods<\/jats:title><jats:p>Primary references were reviewed with specific focus on surgical routes to the sphenoid sinus and sella turcica. Chronology was cross\u2010referenced with contemporary publications by contemporaries. Translations from German were conducted by author AM when necessary.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Markus Hajek elegantly described the surgical approach to the posterior ethmoids and sphenoid sinus in 1904 using a transnasal route. Building on this foundation, Oskar Hirsch described the fully extracranial endonasal transethmoid transsphenoidal approach in 1909. He was first to describe surgical entrance to the sella using this exclusively unilateral endonasal route, which he demonstrated on a cadaver. He reports performing this procedure on a live patient in April, 1910, under local anesthesia in stages over 5\u2009weeks. For better exposure, Hirsch consolidated his method with Killian's submucosal window resection of the posterior nasal septum allowing for bilateral access to the sphenoid sinus and sella, and completed a single stage procedure on a patient in June 1910.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Oskar Hirsch was the first to describe and perform a stepwise surgical approach to the sella using an exclusively extracranial, endonasal, transethmoid, and transsphenoidal approach. He built upon his mentor Markus Hajek's approaches to the posterior ethmoid cells and sphenoid sinus.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>NA: Background information, synthesis from multiple sources emphasizing factual information <jats:italic>Laryngoscope<\/jats:italic>, 133:807\u2013813, 2023<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.30496","type":"journal-article","created":{"date-parts":[[2022,11,24]],"date-time":"2022-11-24T14:01:36Z","timestamp":1669298496000},"page":"807-813","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Hajek and Hirsch: Otolaryngology Pioneers of Endonasal Transsphenoidal Pituitary Surgery"],"prefix":"10.1002","volume":"133","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5055-8286","authenticated-orcid":false,"given":"Nir","family":"Ben\u2010Shlomo","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery, University of Iowa Hospitals and Clinics Carver College of Medicine  Iowa City Iowa USA"},{"name":"Department of Otolaryngology, Head and Neck Surgery, Brigham and Women's Hospital Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albert","family":"Mudry","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery Stanford University School of Medicine  Palo Alto California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Naples","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery, Beth Israel Deaconess Medical Center Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jarrett","family":"Walsh","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery, University of Iowa Hospitals and Clinics Carver College of Medicine  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy R.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brigham and Women's Hospital Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward R.","family":"Laws","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brigham and Women's Hospital Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C. Eduardo","family":"Corrales","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery, Brigham and Women's Hospital Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,11,24]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.2.2382.411"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-190407000-00003"},{"key":"e_1_2_6_4_1","first-page":"953","article-title":"Hirnchirurgie [brain surgery]","volume":"8","author":"Krause F","year":"1905","journal-title":"Dtsch Klin"},{"key":"e_1_2_6_5_1","first-page":"767","article-title":"Zur frage der Operationen an der Hypophyse","volume":"50","author":"Schloffer H","year":"1906","journal-title":"Beitr Klin Chir"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF02819714"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1909.92550210001001a"},{"key":"e_1_2_6_8_1","first-page":"494","article-title":"Remarks on an operative treatment of tumors of the hypophysis","volume":"10","author":"Halstead AE","year":"1910","journal-title":"Gynecol Obstet"},{"key":"e_1_2_6_9_1","unstructured":"ProustR.La Chirurgie de l'hypophyse J Chir (Paris)1908;1:665\u2013680."},{"key":"e_1_2_6_10_1","first-page":"5","article-title":"Ueber eine modifikation der schlofferschen operation von tumoren der hypophyse","volume":"25","author":"Chiari O","year":"1912","journal-title":"Wien Klin Wochenschr"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-190912000-00003"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-194105000-00009"},{"key":"e_1_2_6_13_1","doi-asserted-by":"crossref","unstructured":"MarkusHajek.Annals of Otology Rhinology & Laryngology1941;50:581\u2013583.","DOI":"10.1177\/000348944105000229"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1159\/000273145"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0194-59989770261-4"},{"key":"e_1_2_6_16_1","first-page":"H1","article-title":"Zur Diagnose und intranasalen chirurgischen Behandlung der Eiterung der Keilbeinhohle und des hinteren Siebbeinlabyrinths","volume":"18","author":"Hajek M","year":"1905","journal-title":"Arch Laryngol Rhinol"},{"key":"e_1_2_6_17_1","unstructured":"HamlinH.In memory of prof. 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