神经导航在经单鼻孔蝶窦入路手术中的应用——附78例报告

Application of the Neuronavigation System in Endonasal Transsphenoidal Pituitary Adenoma Resection: a Report of 78 Cases

背景与目的:垂体瘤是颅内最常见的肿瘤之一,以手术治疗为主。保护肿瘤周围正常结构,顺利暴露肿瘤是经鼻蝶窦入路垂体瘤切除术的关键。本文旨在探讨不同影像资料下神经导航在经单鼻孔蝶窦入路手术中的应用。方法:选择临床诊断为垂体瘤患者78例。其中47例患者均应用神经CT导航辅助手术切除垂体瘤,31例患者均在神经MRI导航下,辅助手术切除垂体瘤,对两种手术方法的术中准确性及手术效果进行评价。结果:应用神经导航辅助手术切除78例垂体瘤的过程中均准确找到病灶,导航误差范围1.4～2.9mm。结论:经鼻蝶窦入路垂体瘤切除术中应用神经导航可靠、准确性高,同时可提高手术的疗效。

BACKGROUND ＆ OBJECTIVE： Pituitary adenoma is one of the commonest brain tumors. Neurosurgery is the mainstay of treatment of pituitary adenomas.Precise and direct approach to tumor and avoidance of adjacent structures are the keys to successful operation.In this study, we investigated the application of the neuronavigation system in the resection of pituitary adenomas via endonasal transsphenoidal approach. METHODS： In 78 patients with the clinical diagnosis of pituitary adenomas, 47 patients were operated via endonasal transsphenoidal approach with the assistance of CT neuronavigation and 31 cases were operated via endonasal transsphenoidal approach with the assistance of MRI neuronavigation.The accuracy of the neuronavigation system and the efficacy of the operation were evaluated. RESULTS： Pituitary adenomas were accurately located in operations and the target errors ranged from 1.4mm to 2.9mm. CONCLUSION： The application of neuronavigation in the resection of pituitary adenoma by endonasal transsphenoidal approach achieved a high degree of accuracy and may improve quality of operation.