内窥镜下蝶窦和蝶鞍手术

目的　探讨内窥镜下蝶窦和蝶鞍区手术的体会。方法　内窥镜下治疗脑脊液蝶窦漏 1例 ,蝶窦金属 (子弹 )异物 3例 ,蝶窦囊肿 5例 ,蝶窦霉菌病 5例 ,蝶窦息肉 1例 ,蝶筛窦腺癌 1例 ;垂体腺瘤 2 3例 (微腺瘤 17例 ,侵袭性腺瘤 6例 ) ,颅咽管瘤 2例。结果　蝶窦囊肿、息肉和霉菌病治愈 ;垂体微腺瘤和 1例颅咽管瘤全切术 ;侵袭性腺瘤、1例颅咽管瘤和蝶筛窦腺癌部分切除 ,死亡 1例 (垂体腺瘤术中出血 ) ;脑脊液鼻漏治愈 ;蝶窦异物 2例取出 ,失败 1例。结论　经鼻内窥镜蝶窦和蝶鞍手术定位准确 ,操作简单 ,安全有效 ,但有一定的适应证和并发症 ,须严格掌握和选择。

Trannasal-transsphenoidalendoscopic surgery of the sphenoid sinus and the sella turcica

Objective The primary objective of this study is reporting our experience with transnasal endoscopic technique to management of the sphenoidal and the sellar lesions. Method Forty one patients were management under endoscope who suffered from pituitary adenomas, craniopharyngioma and sphenoidal lesions, et al. Results In forty one cases of the sphenoidal and the sellar lesions, thirty two surgeries were successful. One patient died of bleeding, five developed the foramen of nasal septum, the adhesion of nasal cavity was complicated in three patients. Conclusion The endoscope has the advantage of improved visualization, angled view, and a wide panoramic perspective. The transnasal transspheniodal endoscopic technique is a effective, minimally invasive approach. But there are its disadvantages and occurred severe complication. Surgeons should be understood its feasibility, limits and indication.