内窥镜电视监测下经单鼻腔蝶窦入路垂体腺瘤切除术

内窥镜电视监测下经单鼻腔蝶窦入路切除垂体腺瘤视野清晰.手术中显露照明好,本文创新性应用内窥镜技术治疗7例垂体腺瘤病人,本组男5例,女2例,年龄35～58岁.平均43.9岁.其中微腺瘤(<1cm)1例.小腺瘤(1～2cm)1例,中腺瘤(2～3cm)2例,大腺瘤(>3cm)3例;PRL腺瘤2例,GH腺瘤2例.混合性腺瘤1例,无功能性腺瘤2例.经单鼻腔粘膜下入路1例.粘膜外入路6例.经粘膜外入路直接达蝶窦前壁,手术简捷.符合人体正常生理解剖,同时避免了对鼻中隔的损伤,提高了手术的准确性,减少了手术中的危险性及手术后并发症.

TV monitoring endoscopic resection of pituitary adenoma via unilateral nasal approach

The optic field of endoscopic resection of pituitary adenoma via unilateral nasal approach was clear, the operative exposure and illumination was satisfactory. 7 cases of pituitary adenoma were operated with endoscopic technique via unilateral transnasal-transsphenoidal approach. They are 5 males and 2 females, with range of age of 35 - 58 years. The size of the adenomas: one was a microadenoma ( < 1cm) ,and the others were macroadenomas which included onesmall sized (1-2cm), two median sized (2 -3cm) and three large sized adenomas (> 3cm). Two of them were PRL adenomas,two GH adenomas, one mixed adenoma and two nonfunctional adenomas. The resection was done transsub-mucosally from unilateral nasal cavity in one case and transextramucosally in the other 6 cases. The authors advocate the extramucosal route, because it can get an easy access to the arterior wall of sphenoid sinus directly. In addition, the damage to the nasal septum can be avoided,the operative accuracy was increased and the postoperative complication were reduced.