鼻内窥镜下鼻腔蝶窦径路垂体肿瘤切除术

Endoscopic transnasal sphenoidal approach in hypophysectomy

目的 探讨在鼻内窥下经鼻腔蝶窦垂体肿瘤切除术的术式改进方法及麻醉方法。方法用鼻窦内窥镜经鼻腔蝶窦入路切除垂体肿瘤 42例 ,其中局部麻醉加基础麻醉 37例 ,并作了如下改进 :剥离梨骨翼及后鼻孔上缘区域的粘骨膜瓣和切除梨骨翼及蝶嘴 ,避免了损伤鼻中隔后动脉的可能 ,也增加手术操作的空间。结果 术中出血少 ,手术顺利 ,42例均无并发症发生。术后随访 6～ 35个月 ,均有不同程度的症状改善。结论 用局部麻醉在鼻内窥镜下经蝶窦行垂体肿瘤切除术是一种较简单、安全可行的手术及麻醉方式。

Objective To report the anesthetization and surgical method of transnasal sphenoidal endoscopic approach in hypophysectomy. Methods Forty two cases with pituitary tumor underwent transnasal spenoidal endoscopic surgery and 37 out of 42 accepted local anesthesia and sedation. Results No complications had occurred, the operations went successfully with less blood loss. Postoperative endoscopic follow up period was performed at 6 to 35 months. The symptoms were improved in all patients. Conclusion Our results show that transnasal spenoidal endoscopic approach under local anesthesia in the treatment of pituitary tumor seems to be a safe simple and valuable way.