经翼点入路切除大型垂体腺瘤术后视力、视野受损原因分析

Analysis of Causes of Damage to Eyesight and Visual Field after Microsurgery through Pterional Approach for Large Pituitary Adenomas

目的探讨经翼点入路切除大型垂体腺瘤术后视力、视野受损的原因。方法对我科从2000年至2007年收治的115例大型垂体腺瘤患者术后的视力变化进行回顾性分析。结果115例大型垂体腺瘤患者均达到显微镜下肿瘤全切除者63例,次全切除或大部分切除者52例。术后25例视力和/或视野变差,79例有好转,11例无变化。结论经翼点入路切除大型垂体腺瘤术后患者视力、视野受损可能与:①肿瘤大小和生长方向;②视神经受压时间;③肿瘤质地;④术者的操作;⑤残余肿瘤出血等有关。

Objectives To evaluate the effect of microsurgery through pterional approach for the large pituitary adenoma on eyesight and visual field and its causes. Methods The clinical data of 115 patients with large pituitary adenomas, who underwent microsurgery through pterional approach in our department from 2000 to 2007 year, were analyzed retrospectively. Results The large pituitary adenoma were totally （63 cases） or subtotally （52 cases） resected in all the patients. After the microsurgery through the pterional approach, the eyesight and/or visual field were improved in 79 patients, unchanged in 11 patients and worsened in 25 patients. Conclusions The eyesight and/or visual field in the patients with large pituitary adenomas can be significantly improved by microsurgery through the pterional approach. The damage to the eyesight and/or visual field in the patients with large pituitary adenomas after the microsurgery through the pterional approach is mainly related to the size, orientation of growth and texture of the adenomas, pressing of long duration on visual nerves by the adenomas and the level of surgeon＇s technique.