内镜辅助显微镜切除垂体瘤126例报告

目的探讨内镜辅助显微镜经鼻腔蝶窦入路切除垂体瘤手术。方法126例垂体瘤病人内镜下单鼻孔入路,直达蝶窦前壁蝶嵴,打开蝶窦前壁、鞍底,显微镜下切开硬脑膜,切除肿瘤。结果肿瘤全部切除80例,次全切除26例,大部分切除20例。术后视力和内分泌症状明显改善95例,无脑脊液漏及脑膜炎发生。72例获随访,随访时间6个月至2年,鼻腔干燥3例,未发现鼻中隔穿孔、萎缩性鼻炎、嗅觉减退、鼻中隔粘连等并发症。结论内镜经鼻腔直达蝶窦入路辅助显微镜切除垂体瘤,视野清晰,损伤小,术后恢复快,鼻腔功能恢复好。

Endoscope-assisted microsurgery of 126 patients with pituitary adenoma

Objective To investigate the changes of nasal function in the endoscope-assisted direct endonasal transsphenoidal microsurgery of pituitary adenoma.Methods 126 patients with pituitary adenoma were treated by endoscope-assisted microsurgery via direct endonasal transsphenoidal approach.Results Total tumor resection was achieved in 80 patients,subtotal resection in 26 patients,and partial resection in 20 patients.The endocrine symptoms and impaired vision function got improved in 95 patients.There was no cerebrospinal fluid leakage and meningitis postoperatively.In the postoperative follow-up of 72 patients from 6 months to 2 years,three patients displayed nasal dryness.There were on complications as septal perforation,atrophy rhinitis,hyposmia or septal conglutination.Conclusion The endoscope-assisted direct endonasal transsphenoidal approach can facilitate the rapid postoperative recovery of nasal functions owing to the clear operative visual field and minor nasal injury.