Miyake H, Ohta T
Department of Neurosurgery, Osaka Medical College, Japan.
J Neurosurg. 2000 Feb;92(2):359-60. doi: 10.3171/jns.2000.92.2.0359.
The authors modified a Hardy nasal speculum to improve the access to surgical fields and the handling of various instruments during transsphenoidal surgery. A section of the inferior edge of the speculum was cut out 2 cm from its orifice on both sides. The thickness of the tip of the speculum was also reduced. The authors are prepared to operate using a variety of speculum lengths (the distance between the tip and the cutting level), and this length is selected depending on the distance between the anterior wall of the sphenoid sinus and the surface of the gingiva in the individual patient. A modified nasal speculum was used in transsphenoidal surgery for a pituitary adenoma. With use of this device, the protrusion of the speculum above the gingiva was markedly decreased. Because most instruments are inserted into the inferior portion of the speculum orifice, this approach facilitated the handling of all surgical instruments through the modified nasal speculum. The actual surgical field became shallow and wide, and the long surgical instruments that are generally used for transsphenoidal surgery were unnecessary in most cases.
作者对哈代鼻窥器进行了改良，以改善经蝶窦手术中手术视野的暴露及各种器械的操作。在窥器下缘距开口两侧2 cm处各切除一段。窥器尖端的厚度也有所减小。作者准备使用多种窥器长度（尖端与切割平面之间的距离），该长度根据个体患者蝶窦前壁与牙龈表面之间的距离来选择。一种改良鼻窥器用于垂体腺瘤的经蝶窦手术。使用该装置后，窥器在牙龈上方的突出明显减少。由于大多数器械插入窥器开口的下部，这种方法便于通过改良鼻窥器操作所有手术器械。实际手术视野变浅且开阔，大多数情况下无需使用通常用于经蝶窦手术的长手术器械。
