神经内镜辅助经蝶显微手术切除侵犯中下斜坡的垂体腺瘤

Endoscope-assisted transsphenoidal approach for middle and lower clival extension of pituitary adenomas

目的 探讨神经内镜辅助经蝶切除侵犯中下斜坡垂体腺瘤的手术技巧和临床效果。 方法 采用经口鼻蝶窦入路切除向中下斜坡发展的垂体腺瘤 16例 ,术中配合神经内镜观察 ,术后复查影像学资料、内分泌水平等评估手术效果。 结果 手术近全切除肿瘤 13例 ,次全切除 3例。术后 8例功能性腺瘤内分泌恢复正常者 3例 ,激素水平下降超过 80 %者 4例、未达 80 %者 1例。 结论 神经内镜辅助经口鼻蝶窦入路显微手术可切除侵犯中下斜坡的垂体腺瘤 ,手术效果比较满意。

Objective To explore the microsurgical skills and clinical value of endoscope-assisted transsphenoidal approach for middle and lower clival extension of pituitary adenomas. Methods The sublabial transseptal,transsphenoidal approach assisted by endoscope were applied in 16 cases which invasive middle and lower clivus.CT or/and MRI and pituitary hormones were detected after microsurgery. Results The tumor was achieved approximately total removal in 13 cases and subtotal removal in 3 cases.There were 8 functioning pituitary adenomas and the pituitary hormones decreased to normal level in 3 cases.PRL level decreased more than 80% in 4 cases and less than 80% in 1 cases. Conclusion Endoscope-assisted transsphenoidal approach for middle and lower clival extension of pituitary adenomas can achieve satisfactory effect.