术中X-线定位在神经内镜切除甲介型蝶窦垂体瘤手术中的应用

Application of intraoperative X-ray location in endoscopic surgery for conchiform pituitary adenoma in the sphenoid sinus

目的探讨术中X-线定位在经神经内镜下甲介型蝶窦垂体瘤手术的应用。方法回顾性分析6例甲介型蝶窦垂体瘤病人的临床资料,均采用神经内镜下垂体瘤切除结合术中X-线定位方法。结果术中X-线定位准确4例;2例发生纵向偏差,均纠正。肿瘤全切除5例,次全切除1例。术后激素水平正常,视力视野改善。出现暂时性尿崩1例,治疗后痊愈。无脑脊液鼻漏、垂体功能低下、蝶窦炎发生,无死亡病例。6例病人随访3年,均无复发。结论神经内镜技术结合术中X-线定位是一种治疗甲介型蝶窦垂体瘤的安全、有效方法。

Objective To explore the application of X-ray location in endoscopic surgery for conchiform pituitary tumors in the sphenoid sinus. Methods Clinical data of 6 patients with eonchiform pituitary tumor in the sphenoid sinus were analyzed retrospectively, who received endoscopic resection of pituitary tumor by means of intraoperative X-ray location. Results The intraoperative X-ray location were accurate in 4 patients and longitudinal deviation occurred in 2 which was corrected lately. Total tumor resection was achieved in 5 patients and subtotal resection in 1. All the patients got better with dropping hormone levels and improvement of vision and visual field after surgery. The postoperative temporary diabetes insipidus occurred in one patient, who recovered after treatment. No cerebrospinal fluid rhinorrhea, hypopituitarism and sphenoid sinusitis occurred. There was no death. All the patients were followed up for 3 years and no relapse. Conclusion Endoscopic surgery by means of intraoperative X-ray location is a safe and effective method for conchiform pituitary tumor in the sphenoid sinus.