相关解剖定位标志在经单鼻孔-蝶窦垂体腺瘤显微外科切除术中的应用

目的：探讨相关解剖定位标志在经单鼻孔-蝶窦入路垂体腺瘤显微外科手术中的应用。方法：62例垂体腺瘤经单鼻孔-蝶窦入路显微手术，术中根据蝶嵴、蝶窦开口、蝶窦中隔、鞍底隆凸等解剖标志进行定位。结果：蝶嵴是术中确认手术入路中线的可靠标志，蝶窦开口是蝶窦前壁的重要标志，鞍底隆凸可作为蝶窦腔内鞍底定位标志。62例术中依靠相关解剖标志，均准确定位蝶窦及鞍底，未出现偏差。肿瘤全切除52例，次全切除5例，大部分切除4例。1例部分切除，无死亡病例。结论：熟悉相关解剖标志，有助于该术式的准确定位，从而安全实施手术。

Application of the Anatomic Landmark of Location in Single-nostril Transsphenoidal Microsurgery for Resection of Pituitary Adenoma

Objective:To explore the application of anatomic landmark of precise location in single-nostril transsphenoidal microsurgery for resection of pituitary adenoma.Methods:Sixty-two patients with pituitary adenoma were treated by microsurgery via the single-nostril transsphenoidal approach. The sphenoidal crest, sphenoidal ostium, the septum of sphenoid sinus and the prominentia of sellar floor served as anatomic landmarks during the operation.Results:The sphenoidal crest was a reliable landmark for locating the midline of operative approach, the sphenoidal ostium was an important landmark of anterior sphenoidal wall, and the sellar carinae was used to locat the sellar floor in sphenoidal lacouna. In this study, the sphenoidal sinus and the sellar floor were precisely located in 62 cases, according to the related anatomic landmarks. Total resection was achieved in 52 cases, subtotal resection in 5, most partial resection in 4 and partial resection in 1, no one died.Conclusions:Having an intimate knowledge of the related anatomy landmarks of sphenoid sinus is helpful to precise locating during the operation, and enhances the security of microsurgery for removing pituitary adenoma.