内镜单鼻腔蝶窦入路切除垂体腺瘤

目的探讨内镜单鼻腔蝶窦入路在切除垂体腺瘤中的临床应用。方法应用观察内镜直接自单侧鼻腔进入，于鼻中隔后1／3处作1．0cm的鼻粘膜剥离，离断骨性鼻中隔根部，暴露双侧蝶窦开口，咬开蝶窦前壁进入蝶窦腔。术中内镜伸入鞍内观察。术毕鼻粘膜复位。表面填一小条碘仿纱条，不填塞鼻腔。对216例垂体腺瘤患者进行手术切除，其中微腺瘤50例，大及巨大腺瘤166例。结果138（63．9％）例肿瘤全切，70（32．4％）例部分切除，8（3．7％）例活检。无严重并发症。结论内镜单鼻腔蝶窦入路是一种微创、暴露好、并发症少的切除垂体腺瘤的手术方式。

Endoscope-assisted Endonasal Transsphenoidal Surgery for Pituitary Tumors

Objective To investigate the clinical Application of endoscope- assisted endonasal transsphenoidal surgery to the pituitary tumors. Methods A endoscope was used through a single nasal cavity to open the anterior wall of the sphenoid sinus. Initial incision was in the posterior one third of the nasal septum. Of 216 patients with pituitary tumors undergoing transsphenoidal surgery, 50 had microadenomas, 166 had large or giant adenomas. The postopereation nasal packing was unnecessary for all the patients. Results Of 216 patients with pituitary adenomas, 138 (63.9%) underwent total resection of the tumors, 70(32.4%) subtotal resection and 8(3.7%) biopsy. No severe complications occurred in all the patients. Conclusions The endoscope- assisted endonasal transsphenoidal surgery for the pituitary adenomas can reduce the tissue trauma and postoperative complications, improve the operative visual field and heighten the rate of totally resecting the tumors.