神经导航下经单鼻腔蝶窦入路垂体腺瘤显微外科摘除术

Transsphenoidal microsurgical resection of pituitary adenoma via unilateral nasal approach under neuronavigator

目的 :介绍神经导航系统在经鼻腔蝶窦入路垂体腺瘤摘除术中的应用。方法 :对 8例直径 1.0～ 4.0 cm垂体腺瘤患者手术前均作 2 .4mm层厚的 MR轴位成像 ,于导航计算机工作站行三维影像重建 ,制定手术计划和最佳手术入路 ,手术中以观察棒指引定位。结果 :神经导航下观察棒指引定位蝶窦和蝶鞍中线极为准确 ,同时可指示出垂体腺瘤的大小和范围 ,平均误差 2 .8m m。无一例损伤视神经和颈内动脉 ,术后无严重并发症。结论 :神经导航在经鼻腔蝶窦入路手术中运用 ,提高了手术的准确性 。

Objective: To introduce the application on transsphenoidal microsurgical resection of pituitary adenoma via nasal approach under neuronavigator.Methods:Eight patients with 1.0～ 4.0 cm diameter adenoma were all carried out 2.4mm thick slices MR imaging and were reconstucted in three dimensions by the neuronavigational system before the operation,and also to preject the operation plan and the best operation approach.We use the viewing wand to orient focuses during the operations.Results:We could accurately orient the middle line of the sphenoid and the sphenoidal sellar,while directing the adenoma scale,the mean error of this system was 2.8 mm.No patient was damaged the optical nerve and into carotid artery during the operation.There were no serious postoperative complications.Conclusion:The application on transsphenoidal operation undes neuronavigator could be helpful to increase the operative accuracy and to reduce the postoperative complication.