经鼻中隔中后段垂体肿瘤切除术12例报告

背景与目的：垂体瘤手术经鼻入路较经口入路有较多优点，本文探讨直接经单侧鼻腔蝶窦入路显微手术切除垂体瘤方法。方法：12例垂体肿瘤经CT扫描或MRI明确手术适应证后，手术均采取经单侧鼻腔蝶窦入路显微手术切除肿瘤。结果：全切10例，次全切除1例，部分切除1例。视力、视野恢复7例，并发症主要有尿崩症2例和脑脊液漏1例，无鼻梁塌陷、上门齿麻木及鼻中隔穿孔等并发症，无手术死亡。结论：单侧鼻腔经蝶入路垂体瘤切除术具有鼻腔结构损伤小，切除肿瘤彻底，术后并发症少等优点。

Transsphenoidal Microsurgical Resection of Pituitary Adenomas Via an Unilateral Septal Approach

BACKGROUND & OBJECTIVE: Transsphenoidal microsurgery is the most common approach to resect pituitary adenomas. This study was to evaluate the therapeutic efficacy of transsphenoidal microsurgical by unilateral septal approach for resection of pituitary adenomas. METHODS: Twelve patients with pituitary diagnosed by CT or MRI scan were treated with the transspenoidal microsurgery via a unilateral septal approach from 2004 and 2005. RESULTS: Among the 12 patients, complete removal of the tumor was achieved in 10 cases, subtotal removal in 1 case, and partial removal in 1 patient. Diminished visual acuity and visual field defects improved in 7 cases after surgery. The major complications were diabetes insipidus in 2 cases and cerebrospinal fluid rhinorrhea in 1 case. No patient showed the complication of postoperative dorsum nasi deformities, septal perforations, or incisor tooth numbness. There was no death in this group of patients. CONCLUSIONS: Transspenoidal microsurgery via unilateral septal approach for pituitary adenoma causes less injury of nasal structures. Via this approach, pituitary adenomas can be completely resected more easily and some severe complications can be avoided.