神经导航在经蝶垂体瘤切除术中定位的应用

Application of neuronavigation position for pituitary adenomas through endonasal transsphenoidal approach

目的:探讨神经导航在单鼻孔经蝶窦入路术中定位的应用价值。方法:应用LandmarX(Medtronic,USA)神经导航系统对61例垂体瘤行单鼻孔蝶窦入路手术治疗,术中实时导航定位蝶窦前壁、鞍底、海绵窦等相关结构,切除肿瘤。对肿瘤定位时间(包括导航注册到暴露肿瘤)、定位准确性及并发症进行分析。结果:肿瘤定位时间(27.8±4.6)min,定位准确60例(98.4%),肿瘤全切53例(86.9%),术后脑脊液漏4例(6.6%),尿崩13例(21.3%)。结论:在单鼻孔蝶窦入路切除垂体瘤的手术中,神经导航的使用有助于术中精确定位、缩短手术时间、减少局部结构破坏及海绵窦、颈内动脉损伤的发生,有很高的临床应用价值。

Objective：To evaluate the values of neuronavigation positioned for pituitary adenomas through endonasal transsphenoidal approach. Methods：61 patients were treated by neuronavigation-guided transnassphenoidal microsurgery,during the operation,front wall of the sphenoid,cavernous sinus were positioned accurately and tumor were resection.The positioned time,accuracy of the neuronavigation system,complication and the efficacy of the operation were evaluated. Results：The positioned time was（27.8±4.6） min,positioned accuracy rate was 98.4%,total resection rate was 86.9%,4 cases（6.6%） had CSF leakage,13 cases（21.3%） had diabetes insipidus. Conclusion：It is highly valuable of neuronavigation systerm in the surgery of pituitary adenomas through endonasal transsphenoidal approach to elevate the reliability and accuracy of surgery,reduce the local injury and the serious complications,shorten surgery time.