Acromegaly produces a syndrome of physiological and physical derangeme
nts. Patients afflicted with this disease are often as concerned with
the changes in their appearance as with the pituitary tumor. The exter
nal rhinoplasty approach to transphenoid hypophysectomy has recently b
een shown to improve visualization and to have fewer complications com
pared with the sublabial approach devised initially by Cushing. Three
patients are presented in whom this approach was used to simultaneousl
y treat the physiological derangement of acromegaly and to correct the
nasal deformity.