神经导航辅助经蝶入路手术切除垂体腺瘤

目的探讨神经导航在经蝶入路垂体腺瘤切除术中应用的意义。方法在18例经蝶入路垂体腺瘤切除术中应用神经导航技术。术前行MRI三维影像重建，术中运用导航引导手术入路并监测鞍底开窗的范围、进入鞍内的深度及与颈内动脉、视神经的关系，其中8例最后用神经内镜辅助，随时了解肿瘤切除情况。结果18例经导航下均能精确定位，术中导航误差在1．4mm以内。肿瘤全切除者12例，次全切除者6例，术后无严重并发症。结论神经导航在经蝶窦入路垂体腺瘤切除术中起有效的辅助作用，能增加手术的安全性，但肿瘤切除的范围和程度仍然有赖于医生的技术与经验，必要时须用神经内镜辅助。

Neuronavigator-assisted Microsurgery for Transsphenoidal Pituitary Adenomectomy

Objective To explore the application of neuronavigator - assisted transsphenoidal microsurgery to pituitary adenomectomy. Methods Eighteen patients with pituitary adenomas were treated by neuroneavigator - assisted transsphenoidal micrsurgery. The data obtained by MRI were integrated with neuronavigation system before the operations. The neuronavigation system guided the approach to the sellar base and the dimension of the opened sellar base, the depth within the sella and the relationgship between the internal carotid artery and the optic nerve were observed by this system. The latter operation was assisted by endoscope in 8 patients in order to know the extent of resecting the tumors. Results The important anatomical structures were accurately located in 18 patients. The fiducial errors were within 1.4 mm. Of 18 patients with pituitary adenomas, 12 received total resection of the tumor and 6 subtotally. No serious complications occurred after the operation. Conclusions Neuronavigation system is very helpful to Transsphenoidal Pituitary Adenomectomy and can increase the operative safety, but the extent of removing the tumors still depends on sergeons' experiences and microsurgical skill.