侵及海绵窦垂体腺瘤的诊断与手术方法

目的 探讨侵及海绵窦垂体腺瘤的诊断及手术治疗方法。方法 对21例侵及海绵窦垂体腺瘤头颅CT断层扫描及MRI影像检查，确定诊断，做出分级分型，选择经颅或经蝶两种不同手术入路，采用显像微外科技术经海绵窦硬膜内或硬膜外肿瘤切除。结果 肿瘤全切除6例，次全切除10例，大部分切除4例，术后因并发症死亡1例。手术致动眼神经损伤2例，外展神经损伤3例，三叉神经损伤2例。其中术后1例动眼神经损伤部分功能恢复，三叉神经和外展神经损伤功能完全恢复各1例。结论 侵及海绵窦垂体肿瘤，只要诊断明确，选用合适手术入路，采用显微外科技术，经窦硬膜内或硬膜外方法可达肿瘤全切或次全切除。

Diagnosis and surgery of cavernous sinus-in-vodeal pituitary gland tumor

ObjectiveTo evaluate the diagnosis and sur gercal methods of cavernous sinus-invaded pituitary gland tumor of skull.Methods CT and MRI of skull were done in 21 case of cavernous sinusinvaded pituitary gland tumor,in order to establish the diagnosis and dassification.Operations were performed using micro socopy skill,apporached eieher by skull or sphenoid.THe tumors were rescted thro uph cavernous sinus either subdural or epidural spaces.Results Total resection of tumor were done in 6 cases,subtutal in 10 cases,major-part resection in 4 cas e.one patient was dead folling operatiory due to complication.Oculomotor nerves were injuried in 2 cases during operation,abductional nerve in 3 cases,trigemina l nerve in 2 cases.One oculomotor-injuried patient was partially recovered.Total recovery occured in one abductional-injuried patient and one trigeminal-in-juri ed patient.ConclusionWhen the diagnosis is correct,caver nus sinus-invaded tumo r can be totally or subtotally resected,using correct approach and microscopy su rgery,throvgh either subdural or epidural spaces.