鞍内囊肿经蝶手术治疗及鞍底重建

Treatment of intrasellar cysts by transsphenoidal surgery and reconstruction of sellar floor

目的总结鞍内囊肿经鼻蝶入路手术治疗及鞍底重建的方法及经验。方法回顾性分析鞍内囊肿经鼻蝶入路手术治疗及鞍底重建的12例临床资料。结果术后患者术前症状消失2例,症状缓解10例,均为部分切除,保留部分囊壁。术中出现短暂脑脊液漏4例,经鞍底修复重建后所有患者术后均未出现脑脊液漏,未出现严重的术后并发症。结论鞍内囊肿经鼻蝶入路手术治疗安全有效,可明显改善患者的术前症状。对于术中出现脑脊液漏的病例,及时有效的鞍底修复重建,尽可能做到鞍底解剖还原,能够有效避免术后脑脊液漏及鞍底结构破坏导致的相关并发症。

Objective To summarize the methods and experiences of transsphenoidal surgery for intrasellar cysts and reconstruction of the sellar floor. Methods The clinical data of 12 cases of intrasellar cysts underwent transsphenoidal surgery and reconstruction of the sellar floor were analyzed retrospectively. Results Preoperative symptoms disappeared in 2 cases and symptoms relief in 10 cases. They had all partial resection,remaining part of the cyst wall. Intraoperative temporary cerebrospinal fluid leak occurred in 4 cases. After the reconstruction of the sellar floor,there were no postoperative cerebrospinal fluid rhinorrhea occurred in all patients. No serious postoperative complications were seen in all cases. Conclusions Transsphenoidal surgery for intrasellar cysts and reconstruction of the sellar floor are safe and effective,significantly relief the patients＇ s preoperative symptoms. For intraoperative cerebrospinal fluid leak cases,timely and effective reconstruction of the sellar floor,as far as possible to the anatomical restoration,can effectively avoid postoperative cerebrospinal fluid rhinorrhea and related complications caused by the structural damage of the sella floor.