Gökalp H Z, Egemen N, Culcuoglu A, Naderi S, Zorlutuna A
Department of Neurosurgery and Neurology, School of Medicine University of Ankara, Turkey.
Neurosurg Rev. 1992;15(3):193-7. doi: 10.1007/BF00345930.
Surgery of pituitary tumors has been improved by microneurosurgical methods. However, despite improvements in surgical results, pituitary tumors still continue to represent a problem and, therefore, prompt a search for new surgical techniques. Since Nd:YAG laser energy penetrates the target tissue more deeply than other instruments, its use in the para- and suprasellar region should be considered. It is well known that Visual Evoked Potential (VEP) is a sensitive and objective method for the valuation of compressive or destructive lesions in or around the optic nerve. Visual function correlates with the latency and amplitude of P100 wave in VEP. We used the Nd:YAG laser in 50 transsphenoidal operations of pituitary adenomas. Postoperative effects of the laser on visual function was evaluated by conventional neurophthalmological tests as well as VEP and was compared with preoperative values. Following surgery using Nd:YAG laser, both conventional neurophthalmological tests and VEP values improved due to decompression of optic nerves by tumor removal. In this study, we also examined anterior lobe functions and found that Nd:YAG laser does not affect these functions. Our study shows that Nd:YAG laser has no harmful effects and seems to be very helpful especially for surgery for invading hormone-active adenomas.
显微神经外科方法已使垂体肿瘤手术得到改进。然而，尽管手术效果有所改善，但垂体肿瘤仍然是一个问题，因此促使人们寻找新的手术技术。由于Nd:YAG激光能量比其他器械能更深入地穿透目标组织，所以应考虑将其用于鞍旁和鞍上区域。众所周知，视觉诱发电位（VEP）是评估视神经内或其周围压迫性或破坏性病变的一种敏感且客观的方法。视觉功能与VEP中P100波的潜伏期和波幅相关。我们在50例垂体腺瘤经蝶窦手术中使用了Nd:YAG激光。通过常规神经眼科检查以及VEP评估激光对术后视觉功能的影响，并与术前值进行比较。使用Nd:YAG激光手术后，由于肿瘤切除使视神经减压，常规神经眼科检查和VEP值均得到改善。在本研究中，我们还检查了前叶功能，发现Nd:YAG激光不影响这些功能。我们的研究表明，Nd:YAG激光没有有害影响，而且似乎非常有助于侵袭性激素活性腺瘤的手术。
