神经导航内窥镜辅助下单鼻孔入路垂体腺瘤切除

Navigation-guided endoscopy for the removal of pituitary adenomas by transnasal approach

目的神经导航、内窥镜辅助下垂体腺瘤的经单鼻孔经蝶手术治疗。方法对6例经磁共振成像诊断垂体腺瘤的病人术前进行磁共振成像定位,将影像资料输入导航工作站,作术前手术计划。采用零度及45度镜经单鼻腔,在导航的动态指引下确认鞍底,于内窥镜下实施瘤实质切除。结果本组5例完全切除,1例因为瘤实质较韧而作大部分切除,术后病人的视力均得到了改善。导航预期误差1.48mm,实际误差1.8mm。结论神经导航引导下的经鼻蝶垂体腺瘤手术定位准确,内窥镜下操作对鼻腔的解剖结构影响小、组织损伤轻,病人恢复快。

Objective To assess the role that neuronavigation and endoscopy play in assisting the operations of pituitary adenomas through transnasal and transsphenoidal approach. Methods 6 patients who were diagnosed as pituitary adenomas by MR were performed in MR location before operations. Then the images were transfered into the neuronavigation station, in which the operation plan was designed. With the assistance of the images we orientated and removed the adenomas under zero and 45 degree endoscopy. Rusults 5 received total resection of the tumors and one subtotal, their sight were improved. The prospective error is 1 .45 mm, and the real error is 1 . 8 mm. Conclusion The orientation of transnasal and transsphenoidal operations assisted by neuronavigation is accuracy. The injury of nasal cavity is minimal in operations under the endoscopy,and the recovery are good.