经鼻蝶窦入路神经内镜辅助手术治疗鞍区病变(附26例报告)

Endoscopic endonasal transsphenoidal surgery for saddle lesions: experiences of 26 patients

目的探讨经鼻腔蝶窦入路神经内镜辅助手术的方法。方法全麻下经单鼻腔蝶窦导入神经内镜行26例鞍区病变切除,必要时辅以显微镜。结果24例肿瘤病人中20例全切除,4例次全切除。术后无一例发生脑脊液漏和颅内感染。1例垂体脓肿和1例空蝶鞍均临床治愈。随访6～25个月,10例视力恢复至5.0,6例月经恢复正常,11例内分泌水平恢复正常。结论经鼻腔蝶窦入路神经内镜手术侵袭性小,疗效确切。

Objective To discuss the endoscopic endonasal transsphenoidal surgery experiences with 26 patients. Methods All patients were determined by means of MRI or CT and secretory level test. The lesion was removed via transmononasal sphenoid sinus approach under endoscopic surgery. Results Total resection is achieved in 20 patients and subtotal removal in 4 patients. The follow-up period ranged from 6 to 25 months. There was no postoperative infection or death. The vision recovered to 5.0 in 10 cases, hormone-secreting function rehabilitated in 11 cases, and menses rehabilitated in 6 cases. Conclusion Transmononasal sphenoid sinus approach under endoscope supervision was effective and less invasive.