经蝶窦鼻内镜下垂体腺瘤切除术28例临床分析  

Transnasal-transsphenoidal endoscopic surgery in hypophysectomy

作　　者：韩德民[1] 于振坤[1] 黄志刚[1] 倪 潘锦华[1] 

机构地区：[1]首都医科大学附属北京同仁医院耳鼻咽喉-头颈外科,100730 [2]鑫,100730

出　　处：《耳鼻咽喉（头颈外科）》2002年第2期72-74,共3页Chinese Arch Otolaryngology-Head Neck Surg

摘　　要：目的:探讨垂体腺瘤经蝶窦鼻内镜下切除的可行性及方法.方法:回顾分析1996年4月～2000年4月28例患者接受经蝶窦鼻内镜垂体腺瘤切除手术治疗的治疗效果.全麻下选择肿瘤主体侧及蝶窦发育好的一侧鼻腔进路,将中鼻甲后端1/3切除,沿蝶窦开口扩大蝶窦前壁开口,切开蝶窦粘膜,打开并扩大鞍底,切开硬脑膜,用小刮匙或筛窦钳将肿瘤细心切除.结果:28例中26例得到了全部切除,1例巨大垂体瘤大部切除后,放射治疗.另1例部分切除后用溴隐停药物治疗.随访1年～4年,症状得到了不同程度的改善.结论:经蝶窦鼻内镜垂体腺瘤切除术方法简便、微创、术中视野清晰,是垂体瘤切除的良好方法之一.ve: To evaluate the feasibility and method of transnasal-transsphenoidal endoscopic approach technique in hypophysectomy. Methods: Twenty-eight patients with pituitary tumor (6 males and 22 females,ranging in age from 19 to 69 years old)underwent trasnasal-sphenoidal endoscopic surgery from April 1996 to April 2000 under general anesthesia. The approach was began through the nasal cavity on the side of the major part of tumor and well-developed sphenoid sinus,the 1/3 part of the posterior middle turbinate was removed and mucosa reserved for postoperative filling. The ostium enlarged on the anterior wall of the sphenoid sinus,the floor of sella turcica were fractured and enlarged,then the dura could be exposed and incised cruciformly. The adenoma was then resected with curette or forceps. Result: Among 28 cases, 26 cases had entire resection of the tumor with sphenoid endoscopic approach, 1 case with macroadenoma had subtotal resection with postoperative radiotherapy,another case had partial resection followed by medication. The symptoms were improved in all cases in the period of 1 - 4-year follow-up. Conclusion: The transnasal-sphenoidal endoscopic technique in hypophysectomy have advantages of simple and minitraumatic,that is one of the favorable pituitary tumor surgery.

关 键 词：经蝶窦鼻内镜下 垂体腺瘤 切除术 临床分析 

分 类 号：R736.4[医药卫生—肿瘤]