单鼻腔经蝶垂体瘤切除术蝶鞍体表定位与手术头位关系的研究

Study of relationship between sella turcica surface positioning and head position in monoendonasal transsphenoidal pituitary tumor resection

目的探讨单鼻腔经蝶垂体瘤显微手术蝶鞍体表定位与最佳手术头部体位的关系。方法对18例MRI确诊的垂体瘤病人行单鼻腔经蝶垂体瘤显微手术,术前用"C"臂X光机进行蝶鞍体表定位,探讨OM线与蝶鞍体表定位的关系,并由此确定手术最佳头部体位。结果经上述确定的头部体位可确保双瓣鼻窥器垂直插入直达蝶窦前壁且可直至暴露双侧蝶窦开口,减少鼻腔区手术创伤并使手术经过顺利。结论术前蝶鞍体表定位后所确定的头位可使单鼻腔直接经蝶垂体瘤切除手术直视视野达最大,减少创伤,使手术更为顺利。

Objective To investigate the relationship between sella turcica surface positionion and head position in monoendonasal transsphenoidal pituitary tumor resection. Method We enrolled 18 cases of pituitary tumor underwent monoendonasal transsphenoidal pituitary tumor resection. Before the operation, we located the surface laudmerk of sella turcica by ＂C-arm＂ X-ray, and investigated the relationship between the landmark and lines of OM. The head was positioned with the fine set vericallg. Results In the operation, it was ensured to interpose the special rhinoscope directly to anterior sphenoidal wall and to expose the overall view of double debouchement of sphenoidal sinus that accomplished the operation favourably with the minimal injury of cavitas nasi. Conclusions This head position ensured that the overall view of double debouchement of sphenoidal sinus was exposed. That was resulted in the operation more favourable and less the mucosa injury of nasal cavity.