经单鼻孔-蝶窦入路切除馒袭性垂体腺瘤

目的探讨采用单鼻孔-蝶窦入路切除侵袭性垂体腺瘤的方法。方法对经神经导航及神经内镜辅助的单鼻孔-蝶窦入路手术治疗的37例侵袭性垂体腺瘤患者的临床资料进行回顾性分析。结果镜下全切除21例,次全切除10例,大部分切除6例,无死亡。术后有脑脊液鼻漏2例,1例经保守治疗后治愈,另1例经手术修补治愈。患者术后原有症状均有所改善。结论经单鼻孔-蝶窦入路切除侵袭性垂体腺瘤具有手术时间短、创伤小、安全且并发症少等优点。术中利用神经导航系统和神经内镜辅助手术避免重要结构损伤,提高肿瘤的切除程度,值得推广。

Removing Invasive Pituitary Adenoma by Single-nostril Transsphenoidal Surgery

Objective To explore the method of removing invasive pituitary adenoma by the single-nostril transsphenoidal surgery.Method The clinical data of 37 patients with invasive pituitary adenomas who were treated by neuronavigator and neuroendo- scope-assisted microsurgery through the single-nostril transsphenoidal approach were analyzed retrospectively.Results Of 37 patients with invasive pituitary adenomas,19 underwent total resection of the tumors,11 subtotal and 7 greatly part.No patient died. Postoperative transient cerebrospinal fluid rhinorrbea was found in 2 patients,of whom 1 was cured by conservative treatment and 1 was cured by transsphenoidal repair of the rhinorrhea.All the patients were improved in the symptoms.Conclusions Removing of invasive pituitary adenoma by the single-nostril transsphenoidal surgery has advantages such as safety,time-saving,and no severe complications.The application of the neuroendoscope and neuronavigator to single-nostril transsphenoidal surgery for invasive pituitary adenoma is worthy to be recommended because it can avoid injury to the important structures and enhance a degree of resecting tumor.