内窥镜经鼻内蝶窦垂体腺瘤切除术

目的：探讨内窥镜经鼻－蝶窦入路切除垂体腺瘤,尤其是巨大垂体腺瘤的可行性。方法：分析１９９５年９月～２００１年２月经鼻－蝶窦内窥镜治疗的５０例病人的诊断、手术及预后等临床资料。结果：５０例患者中微腺瘤３例,局限于鞍内的大腺瘤１０例,向鞍上生长未突破蝶窦者７例,向蝶窦内下陷的大腺瘤３０例,其中巨大型肿瘤７例,均向上突破鞍膈向下进入蝶窦。病人术后视力视野均好转,内分泌功能异常得到改善,术后短暂性多尿者６例,术后短暂性脑脊液鼻漏者３例,均为肿瘤巨大者,均经保守治疗而治愈。术后均无鼻腔通气障碍、鼻腔粘连、鼻中隔穿孔等鼻腔并发症及血管损伤性等严重并发症。结论：内窥镜经鼻－蝶窦手术是一种微创外科技术,可完全适用于垂体腺瘤的治疗。     

鼻内镜下垂体腺瘤切除术--附28例报告

目的:探讨鼻内镜下垂体腺瘤手术的治疗经验。方法:鼻内镜下经鼻中隔-蝶窦、鼻内镜辅助经鼻中隔-蝶窦和经鼻腔-蝶窦三种入路手术行垂体腺瘤切除术,共28例。结果:Hardy-Wilson分级Ⅰ级者7例全切除;Ⅱ级者7例,5例全切除,2例次全切除;Ⅲ级者11例,5例全切除,5例次全切除,1例部分切除;Ⅳ级者3例,部分切除。严重并发症蛛网膜下腔出血1例,死亡1例。术后随访2个月～56个月,手术全切除17例中1例复发。结论:鼻内镜下垂体腺瘤手术克服了显微镜下不能观察蝶窦外侧壁重要血管和神经等结构的缺点,经鼻内镜垂体腺瘤切除术具有操作简单、到达蝶鞍比较容易、损伤小的优点,符合微创外科手术原则。     

经蝶窦鼻内镜下垂体腺瘤切除术28例临床分析

目的：探讨垂体腺瘤经蝶窦鼻内镜下切除的可行性及方法。方法：回顾分析1996年4月-2000年4月28例患者接受经蝶窦鼻内镜垂体腺瘤切除手术治疗的治疗效果。全麻下选择肿瘤主体侧及蝶窦发育好的一侧鼻腔进路，将中鼻甲后端1/3切除，沿蝶窦开口扩大蝶窦前壁开口，切开蝶窦粘膜，打开并扩大鞍底，切开硬脑膜，用小刮匙或筛窦钳将肿瘤细心切除。结果：28例中26例得到了全部切除，1例巨大垂体瘤大部切除后，放射治疗，另1例部分切除后用溴鸳停药物治疗，随访1年-4年，症状得到了不同程度的改善。结论：经蝶窦鼻内镜垂体腺瘤切除术方法简便，微创，术中视野清晰，是垂体瘤切除的良好方法之一。     

鼻内镜下鼻腔鼻窦恶性肿瘤切除术

鼻内镜下鼻腔鼻窦恶性肿瘤切除术是近年来兴起的治疗鼻腔鼻窦恶性肿瘤的一种有效方法.本文主要对其可行性、手术适应证及禁忌证、手术方法及切除范围、术后处理以及手术疗效等方面做一综述.     

经鼻内窥镜垂体腺瘤切除术

目的 探讨鼻内窥镜在垂体瘤手术中的应用价值和适应证。方法开展了２４例经鼻内镜 体腺瘤切除手术。２４例垂体腺回味各２０例为经鼻蝶窦进路，４例为经鼻中隔蝶窦进路。结果 ２０例经鼻蝶窦进路瘤组织得到了完全切除，手术所需时间较经鼻中隔蝶窦进路显微外科手术明显缩短。４例经鼻中隔蝶窦进路中３例瘤组织完全切除，１例非分泌性腺瘤患者因瘤组织侵犯鞍旁及海绵窦，仅行大部分切除。所有秫后能、视力障碍和闭经泌乳等症状均有     

鼻内镜下腺样体切除术

腺样体和扁桃体肥大是儿童鼾症的主要原因,对儿童生长发育有一定的影响,如呼吸障碍、发育障碍,或出现腺样体面容,特别是腺样体肥大常可引起儿童咽鼓管功能障碍导致分泌性中耳炎,且久治不愈。彻底解决腺样体肥大最有效的方法是手术切除。1资料和方法1.1临床资料。2002～2003年浙     

经鼻内镜下鼻甲黏骨膜下切除术

我科从2002年1月～2006年12月对18例慢性肥厚性鼻炎患者应用鼻内镜直视下做下鼻甲黏骨膜下切除术,取得满意效果,报道如下。1资料与方法1.1诊断标准。①持续性鼻塞3个月以上;②局部检查:下鼻     

鼻内镜下鼻腔鼻窦恶性肿瘤切除术

鼻内镜下鼻腔鼻窦恶性肿瘤切除术是近年来兴起的治疗鼻腔鼻窦恶性肿瘤的一种有效方法.本文主要对其可行性、手术适应证及禁忌证、手术方法及切除范围、术后处理以及手术疗效等方面做一综述.     

鼻内镜下鼻腔鼻窦恶性肿瘤切除术

鼻内镜下鼻腔鼻窦恶性肿瘤切除术是近年来兴起的治疗鼻腔鼻窦恶性肿瘤的一种有效方法.本文主要对其可行性、手术适应证及禁忌证、手术方法及切除范围、术后处理以及手术疗效等方面做一综述.     

鼻内镜下腺样体切除术并发症分析

腺样体肥大是引起儿童阻塞性睡眠呼吸暂停低通气综合征最常见的病因,而且可导致邻近器官的病变。若长期得不到治疗,可出现其特有的腺样体面容。严重者甚至影响患儿的生长发育。因此,确诊后应尽早施行腺样体切除术。目前,临床多采用鼻内镜下经鼻口联合径路腺样体切除术。术中由于患者的个体因素、器械的使用、手术技巧等问题,会导致一些手术并发症的发生。本文就我科在手术中所遇到的问题和采取的相应措施总结如下。     

内镜下经鼻蝶入路切除后颅窝斜坡区颅咽管瘤

颅咽管瘤是一种少见的颅内良性肿瘤，占颅内原发件肿瘤的1％～3％，手术是治疗此肿瘤的首选方法。以往采取经颅或经蝶入路显做镜下切除肿瘤，近年来随着颅底内镜外科技术的发展，有学者应用内镜经鼻蝶鞍膈上入路进行鞍上池、鞍区和第三脑室颅咽管瘤切除，取得了较好的手术效果，但后颅窝斜坡区颅咽管瘤是否适合经鼻内镜手术切除？目前少见文献报道。近期我们应用内镜采取鼻中隔经蝶入路的手术方法切除1例后颅窝斜坡区颅咽管瘤并获得成功。现就此病例的手术方法，手术中注意事项进行探讨。     

鼻内镜下经蝶窦入路垂体肿瘤切除术的麻醉选择

目的：探讨在鼻内镜下经鼻腔蝶窦垂体肿瘤切除术的麻醉方法。方法：在鼻内镜下经鼻腔蝶窦入路切除垂体肿瘤56例,其中8例在全身麻醉下完成,48例局部麻醉加基础麻醉下完成。结果：所有患者都顺利完成手术,56例均无手术并发症,其中在局部麻醉加基础麻醉下完成的48例,术中出血量明显减少,生命体征平稳,无呻吟挣扎,手术顺利。结论：局部麻醉加基础麻醉下行鼻内镜下经鼻腔蝶窦垂体肿瘤切除术简单、安全,且效果好。     

Complications of sphenoid sinus surgery and transsphenoidal hypophysectomy

Sphenoid sinusitis may present with nonspecific symptoms, particularly when other sinuses are also inflamed. Diagnosis can be made with a combination of history, physical examination, and imaging. Prompt treatment is essential to avoid possible complications. Medical therapy focused on infection, inflammation, and obstruction may be adequate for resolution, but surgical intervention may be required in certain situations.     

Anaesthesia in endoscopic sinus surgery

The aim of this study was to evaluate the methods of anaesthesia used in 1,460 patients (677 females and 783 males), aged 4 to 79 years, who were consecutively operated on with a functional endonasal endoscopic approach (FESS) or by an endoscopic endonasal approach (ESS) by one surgeon (AD) in the period from 1987-2001. The included patients presented a variety of disorders within the nose and sinuses. Many of the patients had sinonasal polypoid disease, which had gradually expanded over years and was causing pressure to neighbouring structures. Several had undergone previous multiple surgical procedures altering the original anatomy. However, the majority of the patients had been treated surgically for acute recurrent and/or chronic infections, others for sinogenic headache, benign tumours/mucoceles and smell disorders. The intention of looking into the anaesthetic procedures being used was to clarify the needs for a differentiated anaesthetic approach to different surgical tasks. It is of crucial importance for an optimal surgical result that both the patient and surgeon feel absolutely comfortable during the operation. Local anaesthesia can be used in minor surgery on selected patients and is definitely suitable even for residents in training. General anaesthesia is preferred in most cases by both patients and surgeons. The conclusion of this paper is that total intravenous anaesthesia (TIVA) in addition to oxygen-enriched air through a laryngeal mask airway (LMA) should be the anaesthetic procedure of choice, at least in our experience.     

Limits in endoscopic ear surgery

HNO - In recent decades, endoscopic ear surgery (EES) has been rapidly evolving, expanding its boundaries from the middle ear to the lateral skull base. Nonetheless, the advantages of the...