侵袭海绵窦的垂体腺瘤的临床特点及经蝶显微手术治疗

目的 报道侵袭海绵窦的垂体腺瘤的临床特点及经蝶显微切除手术的临床效果。方法 以1998年10月至2005年10月，对61例侵袭海绵窦的垂体腺瘤均采用经口-鼻-蝶窦入路，先切除鞍内、海绵窦内及窦旁发展的肿瘤，再切除鞍上部分肿瘤。结果 本组无手术死亡，近全切除29例，次全切除23例，大部分切除9例。视力、视野好转45例。6例术前动眼神经损伤症状全部消失。50例随访3个月-6年，肿瘤消失35例，少量肿瘤残留9例，可疑残留6例。结论 侵袭海绵窦的垂体腺瘤具有海绵窦内脑神经损害表现及内分泌变化显著的特点，应用显微外科技术经蝶入路手术切除可以取得良好的临床效果。

The clinical feature and effect of transsphenoidal microsurgery on pituitary adenoma invading the cavernous sinus

Objective To report the clinical characteristic and effect of transsphenoidal microsurgery of pituitary adenoma invading the cavernous sinus. Methods Sixty-one patiens with pituitry adenoma invading the cavemous sinus underwent transsphenoidal operation. Tumors in the sella turcica and cavernous sinus were removed first, and then removed the tumors above the diaphragma sellae from oct. 1998 to Oct. 2005. Results No medality. 29 tumors were nearly totally removed, 23 tumors were subtotally resected, 9 were partially resected. The vision and field of vision of 45 cases were improved. The symptom of Injury of oculomotor nerve of 6 cases were disappeared, 50 cases were follow-up for three months to six years, 35 tumors disappeared, 9 tumors partially remained, 6 tumors questionable remained. Conclusion The pituitary edenoma invading the cavernous sinus have the clinical manifestation of cranial nerve damage and prominent endocrine change. Transsphenoidal microsurgery could obtain favorable clinical effect.