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目的 评价神经导航系统在垂体瘤显微手术中的应用。方法 在21例垂体瘤手术中，应用StealthStation神经导航系统指导手术操作，其中17例行经蝶手术，3例行扩大前中颅底硬膜外入路，1例行扩大前颅底硬膜外入路＋经蝶手术。神经导航术中定位中线结构、蝶窦前壁、鞍底、以及海绵窦、颈内动脉、斜坡等，并用以判断肿瘤切除程度。结果 21例平均坐标误差为1．14～3．91mm平均1．63mm；预期准确性为1．54～4．82mm平均2．72mm。21例垂体瘤全切14例，次全切除5例，大部切除2例。术后10例出现一过性尿量增多，1例下视丘损伤，无脑脊液漏和颅内感染，无手术死亡。结论 对一些巨大、复发或解剖定位结构不清的垂体瘤进行手术时，神经导航提供实时三维定位，有助于提高肿瘤切除率，减少手术并发症。
Objective To evaluate the application of neuronavigation system in the microsurgery of pituitary tumors. Methods In 21 cases of pituitary tumor surgery, StealthStation neurosurgical system was used to guide the operation. Among them, 17 cases underwent transsphenoidal surgery, 3 cases underwent extended anterior middle skull base epidural approach, and 1 case underwent extended epidural anterior skull base. Approach + transsphenoidal surgery. In the neuronavigation surgery, the midline structure, anterior sphenoid sinus, saddle base, and cavernous sinus, internal carotid artery, slope, etc. were located and used to judge the degree of tumor resection. Results The mean coordinate error of 21 cases was 1.14 to 3.91 mm (average 1.63 mm), and the expected accuracy was 1.54 to 4.82 mm (average 2.72 mm). Twenty-one cases of pituitary adenomas were totally resected in 21 cases, subtotal resection in 5 cases, and subtotal resection in 2 cases. After 10 cases, transient urine output increased, 1 hypothalamic injury, no cerebrospinal fluid leakage and intracranial infection, and no operative death. Conclusion When performing surgery on some giant pituitary tumors with recurrent or anatomic structures, neuronavigation provides real-time three-dimensional localization, which helps to increase the rate of tumor resection and reduce surgical complications.