扩大额下硬膜内入路显微切除大型垂体腺瘤

目的 探讨扩大额下硬膜内入路显微手术切除大型和巨大型垂体腺瘤的手术方式和临床疗效。方法 采用扩大额下硬膜内入路切除体腺瘤，对生长入蝶窦内的肿瘤则磨除蝶骨平板切除窦内肿瘤，显微切除鞍上肿瘤时应解剖出垂体柄和受挤压的垂体组织并加以保护，以免术中损伤。结果 16例大型和巨大型垂体瘤全切除13例（81.25％），次全切除3例，无重残及死亡病例。结论 该手术入路的显微手术能有效地提高大型和巨大型垂体腺瘤的全切除率，亦适用于鞍区的肿瘤的显微手术。

Microsurgery of large pituitary aden omas by extended subfrontal approach

Objective To study the effect of large and huge pituitary adenomas resected via the extended subfrontal approach Methods Tumors with large suprasellar extensions or parasellar extensions can be removed completely via this approachAdenomas within the sphenoidal sinus can be removed in 7 cases by cutting the sphenoidal plate and the tubercutum sellae and the anterior wall of sellsa floor Results In our series,total restriction was achieved in 8125%,without death or severe complications Conclusions Giant invasive pituitary adenomas can be removed more sufficiently via this approach and excellent outcomes were achievedThis approach is good for the tumors in the anterrior cranial fossa and the sellar area