摘要
目的 探讨经鼻内镜下蝶鞍手术方法的适应证、应用价值及应用前景,并探索性提出经鼻-经鼻中隔-经筛-经蝶入路摘除蝶鞍巨大肿块。方法 蝶鞍占位性病变病人共7例:垂体微腺瘤5例、巨大垂体腺瘤1例、鞍区炎性坏死性肉芽肿1例。6例采用经鼻-蝶入路;1例采用经鼻-鼻中隔-筛-蝶入路。结果 术前症状在术后均有不同程度的改善(除1例术前有一眼失明者外),无1例出现严重并发症,6例蝶鞍占位获得全切;1例获得次全切。结论 经鼻内镜下摘除蝶鞍占位性病变具有很好的推广应用前景。内镜下经鼻-鼻中隔-筛-蝶入路为蝶鞍巨大肿块的切除提供了一条较佳的手术途径。
Objective To explore the indication, clinical value and prospect of transnasal endoscopic transphenoidal technique in treating sella lesions; and try to use endoscopic transnasal - transseptal - transethmoidal - transphenoidal approach to remove invasive macroadenoma. Methods This group included 7 patients: 5 microadenomas, 1 inflammatory necrotic glanuloma, and 1 invasive macroadenomas. The endoscopic transnasal-transphenoidal technique was applied for management of 6 patients with sella turcica lesions, and endosapic transnasal-transseptal-transethmoidal- transphenoidal approach was used to remove 1 invasive macroadenomas. Results The 2 - 9 months follow-up by CT Scan or MRI indicated that total removal of the lesions in six patients was achieved, one patient was confirmed having a subtotal resection. Preaperative symptoms disappeared or reduced after operation. No new postoperative endocrinological or neurological deficits occurred. Conclusion The transnasal endoscopic approach provides a valuable method for the management of the sella lesions. The modified surgical technique that facilitates better removal of the macroadenoma with less accessible pre-sella extension demonstrates its feasibility.
出处
《中国耳鼻咽喉颅底外科杂志》
CAS
2001年第3期129-132,共4页
Chinese Journal of Otorhinolaryngology-skull Base Surgery
关键词
垂体肿瘤
外科学
蝶鞍
腺瘤
内窥镜术
Pituitary tumor/sury
Sella turcica/surg
Adenoma/surg
Endoscopy