经单鼻孔蝶窦入路神经内镜下切除垂体腺瘤

目的 介绍经单鼻孔蝶窦入路神经内镜下切除垂体腺瘤的经验及体会。方法 对16例垂体腺瘤病人采用经单鼻孔蝶窦入路行神经内镜下垂体腺瘤切除术，其中微腺瘤3例，大腺瘤12例，巨型腺瘤1例。功能性腺瘤14例，其中PRL腺瘤6例，GH腺瘤4例，混合性（PRL GH）腺瘤4例；无功能性腺瘤2例。结果 内镜下全切除肿瘤14例，近全切1例，大部切除1例；无死亡，无脑出血、视神经损伤、脑脊液鼻漏及其他鼻腔并发症发生；2例术后出现一过性多尿，经治疗术后1周恢复正常。随访3-6个月，原有症状均有所改善，异常增高的激素水平均降至正常，MRI检查显示下一例肿瘤复发。结论 内镜下经单鼻孔蝶窦入路垂体腺瘤切除术具有深部照明好，鼻腔结构损伤小，切除肿瘤彻底，术后并发症少，病人恢复快等优点。

Single-nostril transsphenoidal endoscopic pituitary adenoma surgery

Objective To introduce the experience of the single-nostril transsphenoidal endoscopic pituitary adenoma surgery. Methods 16 patients were treated through the single-nostril transsphenoidal endoscopic pituitary adenoma surgery. The patients were distributed in 3 microadenomas, 12 macroadenomas, and 1 huge adenoma. 14 hormone-secreting adenomas (6 PRL-adenomas, 4 GH-adenomas, 4 PRI-GH adenomas), 2 nonsecreting adenomas. Results 14 patients underwent total resection, 1 patient subtotal resection and 1 patient largely resection. There was no mortality in this series. Cerebral hemorrhage, cerebrospinal rhinorrhea, optic nerves injury, internal carotid injury was not found. Two cases presented with temporary diabetes insipidus. With 3-8 months follow-up, the symptoms of headache and visual disturbance were cured or improved, the increased hormone level were decreased to normal postoperatively. There was none recurrent case. Conclusion The single-nostril transsphenoidal endoscopic pituitary adenoma surgery offers an increased illumination and magnification during operation, as well as less injury of nasal structures, be helpful to removing adenomas completely, without severe complications.