神经导航系统在经蝶入路垂体瘤切除术中的应用

Application of neuronavigation in transsphenoid resection of pituitary adenoma

目的:评价神经导航系统在经单鼻腔蝶窦入路垂体瘤切除手术中的应用。方法:10例患者术前均在导航系统工作站中进行图像三维重建,制定手术计划,标记重要结构。术中在导航的引导下定位,切除肿瘤。结果:10例患者均在神经导航引导下经鼻蝶入路顺利到达肿瘤部位,平均注册误差2.0mm,肿瘤全切除7例(70%),次全切除3例(30%),术后头痛、视力下降、视野缺损等临床症状均有不同程度的改善,术后垂体有关激素在1～2周内恢复正常。4例出现尿崩症,经治疗2周后缓解。结论:神经导航辅助下经鼻蝶垂体瘤切除术具有定位准确、创伤小、安全性高等优点,有利于肿瘤全切,术后并发症少。

OBJECTIVE：To evaluate the value of the application of neuronavigation in transsphenoid resection of pituitary adenoma.MESULTS：Ten patients accepted images reconstruction,operation plan design and all important structures mark were finished in workstation of navigation system before surgery.All section procedures were done under the guide of navigation system.RESULTS：The tumors were accurately located under the guide of navigation system.The mean error was 2.0 mm.Total resections were performed in 7 cases （70%） and subtotal resections in 3 cases （30%）.Headache,visual acuity and visual-field defect were relieved in all patients.Postoperative endocrine secretion improved in all patients from one to two weeks.Transient diabetes occurred in 4 cases and improved after therapy in two weeks.CONCLUSION：Ne uronavigation is helpful for accurate location,increasing tumor total resection rate and with less surgical complications.