经单侧鼻孔-蝶窦入路显微切除垂体瘤

目的探讨经单鼻孔蝶窦入路切除垂体瘤的显微手术技巧及术后处理。方法对12例经CT扫描和MRI检查确诊为垂体瘤患者,采用经鼻蝶入路切除肿瘤。术中将扩鼻器直抵蝶窦前壁,将鼻中隔完整地推向对侧,凿除蝶窦前壁骨质,经鞍底切除肿瘤。结果行肿瘤10例全切除,2例大部分切除,无严重并发症发生,无死亡。结论经单鼻孔蝶窦入路切除垂体瘤创伤小,安全性高,并发症少,术后病人恢复快,省时易行,对于位于鞍内和大部位于鞍内的垂体瘤是一种有效的术式。

Pituitary adenomas resection by endonasal transsphenoidal approach

Objective To study the operative procedure and postoperative treatment of removing pituitary adenomas by endonasal transsphenoidal approach with microsurgery. Methods All patients were operated via endonasal transsphenoidal approach .Operation were performed without incision the speculum straightly upon to the unterior wall of the sphenoidal sinus.As expand in the speculum ,the middle septum was perfectly pressed to the opposite side .Under the operative microscope ,the anterior wall mucosa of the sphenoidal sinus was dissected away ,the anterior wall bone of the sphenoidal sinus was chipped off and then the sinus approached .Other steps were as usual .Results Total removal of the tumors in 10 cases, partial removal in 2,none of the patients were suffered from permanent severe complications and the operative mortality was zero.Conclusion This approach is less destructive ,less complications safety and save time easy to perform .