单鼻孔经蝶与眶上锁孔入路切除垂体腺瘤的显微手术比较

目的比较单鼻孔经蝶与眶上锁孔入路显微手术切除垂体腺瘤的效果。方法手术治疗垂体腺瘤36例,其中采用单鼻孔经蝶入路25例,眶上锁孔入路11例。术中均采用神经内镜辅助技术。结果单鼻孔经蝶入路全切肿瘤22例（88%,22/25）,次全切除3例（12%,3/25）;眶上锁孔入路全切9例（81.8%,9/11）,次全切2例（18.2%,2/11）。术前有视力障碍者,85.7%（18/21）术后视力得到改善,其它临床症状较术前均有明显不同程度的好转,手术效果满意。结论两种不同入路有各自的优点及适应证,术前应根据肿瘤的不同特点选择不同的手术入路。利用神经内镜辅助显微手术有助于提高肿瘤全切率和减少术后并发症。

Compariation between Both Endonasai Transsphenoidal Approach and Supraorbital Keyhole Approach Applied to Microsurgery for Pituitary Adenomas

Objective To evaluate the therapeutic effects of microsurgery through endonasal transsphenoidal and supraorbital keyhole approaches on pituitary adenomas.Method Of 36 patients with pituitary adenomas,25 underwent neuroendoscope-assisted microsurgery through endonasal transsphenoidal approach and 11 through supraorbital keyhole approach.Results Of 25 patients undergoing the microsurgery through the endonsal transphenoidal approach,22 received total resection of the tumors and 3 subtotal.Of 11 patients undergoing the microsurgery the through supraorbital keyhole approach,9 received total resection of the tumors and 2 subtotal.The vision of 85.7%(18/21)patients with visual disturbance before the operation was improved after the operation.All the patients were improved in clinical symptoms after the operations.Conclusion Each of both the approaches has its strong points and indication.The operative approach should be selected according to the different characteristics of the different tumors.The microsurgery assisted by neuroendscope can enhance the curative effect and decrease the postoperative complications in the patients with pituitary adenomas.