鼻内镜下经鼻腔-蝶窦入路切除垂体大腺瘤13例

目的：了解鼻内镜技术用于经蝶窦入路切除垂体大腺瘤的可行性。方法：对13例垂体大腺瘤患者采用鼻内镜下经鼻腔-蝶窦入路切除术式。结果：肿瘤全切除9例(69．2％)，大部切除3例(23．1％)，手术失败1例(7．7％)。术后1周内视力、视野明显改善10例(76．9％)，其中7例接近或完全恢复正常。除2例短暂脑脊液漏外，无其他严重并发症及死亡病例发生。结论：鼻内镜用于经鼻腔-蝶窦入路切除垂体大腺瘤可获得满意的临床效果，但应注意避免术中出血、解剖变异、鞍旁组织向鞍内膨出、复发性垂体大腺瘤及术后不适当的瘤腔处理对鼻内镜手术操作及疗效的影响。

Resection of giant pituitary adenomas through transnasal and transsphenoidal approach with nasoendoscope

Objective:To investigate the feasibility of transnasal and transsphenoidal surgery for giant pituitary adenomas with nasoendoscope.Method:The giant pituitary adenomas were resected by the transnasal and transsphenoidal surgery with nasoendoscope in 13 patients.Result:The tumors were totally resected in 9 cases ( 69.2 %) ,subtotally in 3 cases( 23.1 %) and the resection failed in 1 ( 7.7 %). Vision and visual field were significantly improved in 10 patients ( 76.9 %) one week after the operations, of whom 7 had nearly or completely normal vision and visual field. There were no sevious complications or death except transient cerebro spinal fluid leakage in 2 patients.Conclusion:It should be noted that the operative manipulation and curative effect of nasoendoscopic surgery on the giant pituitary adenomas may be affected by some factors such as the hemorrhage during the operation, anatomical abormality, parasellar tissue progecting into the sella, postoperative improper treatment and so on.