神经导航辅助下经单鼻孔-蝶窦入路垂体腺瘤切除术(附21例报告)

Neuronavigation assisted endonasal transsphenoidal pituitary adenoma resection(report of 21 cases)

目的探讨神经导航系统在经单鼻孔蝶窦入路垂体腺瘤切除术中的应用。方法在21例垂体腺瘤患者中,应用神经导航系统指导定位,识别鞍区相关结构并引导手术操作。结果神经导航系统平均注册误差为0.8mm。本组全切除18例、次全切除3例。术后15例内分泌化验恢复正常,16例头痛好转,10例视野、视力障碍好转;8例出现一过性尿崩症,余未见其它并发症。结论神经导航系统在手术中定位准确,可以实时准确的指示术区的有关解剖结构,并引导手术操作,有效地减少了创伤,提高了手术疗效。

Objective To introduce the application of neuronavigation in the resection of pituitary adenomas by endonasal transsphenoidal approach.Methods Twenty-one patients were applicated neuronavigation in the resection of pituitary adenomas by endonasal transsphenoidal approach.The neuronavigation system provides realtime location and information of the structure around sellar area,gudies the operation.Results The mean fiducial error of neuronavigation system was 0.8 mm.Total tumor removal was achieved in 18 patients,subtotal removal in 3.Recovery of hormone level,recovery of headache,recovery of eyesight and transient diabetes insipidus were found in 15,16,10 and 11 cases,respectively.There was no severe complications.Conclusion The application of neuronavigation assisted endonasal transsphenoidal pituitary adenoma resection is helpful for accurate location and point out structure around sellar area.It is quite useful for the tumor removal,improving operation effect.