神经内镜辅助下经蝶单鼻孔入路切除垂体腺瘤

Neuroendoscopic Microsurgery of Pituitary Adenomas through Unilateral Endonasal Transsphenoidal Approach

目的介绍经单鼻孔入路神经内镜下切除垂体腺瘤的手术方法、疗效及体会.方法11例垂体腺瘤患者采用此手术方法予切除.结果内镜下肿瘤全切8例,部分切除3例,无严重并发症及死亡.术后随访6～12月,4例视力、视野障碍显著改善,3例月经恢复,泌乳停止,2例肢端肥大骨痛症状明显好转,1例视力下降改善不显著.结论单鼻孔入路神经内镜下垂体腺瘤切除术创伤小、手术时间短、手术视野广、照明好、并发症少、病人恢复快等优点.

Objective To explore the operative skills and experience of the neuroendoscope-assisted unilateral endonasal transsphenoidal microsurgery of pituitary adenoma.Methods The clinical data of 11 patients with pituitary adenomas who had accepted endonasal transsphenoidal microsurgery from Jan uary 2004 to June 2006 were analyzed retrospectively.Results Total removal of tumors was made in 8 cases,subtotal removal in 3 cases.No death happened postoperatively.The median time of followup was 6～12 months.During the followup,the visual disorder was improved in 4 cases.Megalakria was relieved obviously in 2 cases and galactorrhea was cured in 3 cases.Conclusions Neuroendoscope-assisted endonasal transsphenoidal surgery for pituitary adenomas makes maximal use of natural space of nasal cavity,which has many advantages,such as direct approach,minimal invasion,short operative time,and less postoperative complications.It is a safe and effective method for the treatment of pituitary adenomas.