论文部分内容阅读
目的探讨神经内镜技术和手术显微镜结合经单鼻孔经蝶入路切除垂体瘤的临床应用及手术技巧。方法对14例经CT扫描和MRI检查确诊为垂体瘤患者在神经内镜辅助下经单鼻孔入路,磨除蝶窦前壁,暴露鞍底,显微镜下切除垂体瘤主体后内镜下切除残余肿瘤。结果全切11例,近全切3例。术后3例出现一过性脑脊液漏,尿崩5例。7例内分泌检查正常,8例视力好转,无严重并发症发生。结论内镜辅助单鼻孔经蝶入路能良好地显示蝶窦、鞍区等结构,弥补显微镜的盲区,而手术显微镜能提供三维视野,在经鼻入路过程及切除鞍区肿瘤主体具有优势,二者结合有利于肿瘤的全切除,手术创伤小,并发症少,患者恢复快。
Objective To investigate the clinical application and surgical technique of combining endoscopic neurosurgery with surgical microscopy in the treatment of pituitary adenoma by single nostril transsphenoidal approach. Methods 14 cases of pituitary adenomas diagnosed by CT scan and MRI examination underwent endoscopic nostril resection with the help of endoscopic approach. Tumor. Results The total cut in 11 cases, nearly complete cut in 3 cases. Postoperative three cases of transient cerebrospinal fluid leakage, diabetes insipidus in 5 cases. 7 cases of endocrine examination was normal, 8 cases of visual acuity improved, no serious complications. Conclusions Endoscopic assisted single nostril transsphenoidal approach can well display sphenoid sinus, saddle area and other structures to make up for the blind spot of the microscope. The surgical microscope can provide three - dimensional visual field, which has advantages in transnasal approach and resection of tumor main body in the sellar region, The combination of the two is conducive to tumor resection, surgical trauma, fewer complications, patients recover quickly.