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目的:探讨鼻内镜下鼻中隔-蝶窦入路垂体腺瘤显微切除术的方法及并发症的预防。方法:采用唇龈沟切口鼻内镜下经鼻中隔-蝶窦径路显微切除垂体腺瘤19例,肿瘤施行囊内切除并用无水乙醇烧灼,用唇筋膜和鼻中隔骨片重建鞍底,其中肿瘤全切除17例,次全切除2例。结果:7例术前视力损害者中6例得到不同程度的恢复,所有病例症状改善,术后除1例视力一过性减退和2例嗅觉一过性减退外,其余病例均无脑脊液鼻漏和脑膜脑膨出等并发症。术后随访3个月~3年,17例全切除者肿瘤无复发,2例次全切除者肿瘤生长缓慢。结论:采用鼻中隔-蝶窦入路垂体腺瘤显微切除术,术中囊内烧灼可有效地防止或减缓术后肿瘤复发,术后唇筋膜和鼻中隔骨片重建鞍底可防止相应并发症。
Objective: To explore the method of nasal endoscopic resection of nasal septum and sphenoid sinus pituitary adenoma and the prevention of complications. METHODS: Twenty-nine patients with pituitary adenomas underwent nasal septum-sphenoid sinus pathology under endoscopic nasal septum and endoscopic gingival crevicular incision. The tumors were excised intracapsularly and cauterized with absolute ethyl alcohol. The sella was reconstructed with lip fascia and nasal septum. Tumor resection in 17 cases, subtotal resection in 2 cases. Results: Of the 7 cases, 6 cases were recovered with different degrees of preoperative visual acuity, all cases had improved symptoms, one case had transient vision loss and 2 cases had amelioration of olfactory function after operation. No other cases had cerebrospinal fluid rhinorrhea And brain meningocele and other complications. The patients were followed up for 3 months to 3 years. No recurrence was found in 17 cases of total resection and 2 cases of subtotal resection showed slow tumor growth. CONCLUSIONS: Nasal septum - sphenoid sinus pituitary adenoma microsurgical resection, intraoperative balloon cessation can effectively prevent or slow postoperative tumor recurrence, postoperative lip fascia and nasal septum reconstruction of the saddle end to prevent the corresponding complications .