Kashio Akinori, Suzuki Mitsuya, Watanabe Hidetoshi
Department of Otolaryngology, Tokyo Metropolitan Police Hospital, Tokyo.
Nihon Jibiinkoka Gakkai Kaiho. 2005 Nov;108(11):1077-82. doi: 10.3950/jibiinkoka.108.1077.
Hardy's operation using a microscope has long been the standard for treating pituitary adenoma. A new endonasal approach to the sella using an endoscope combined with a navigation system has been reported, which we used to conduct endocopic endonasal hypophysectomy from October 2000 to June 2003 in 11 patients with pituitary lesions. We introduced an angle-dependent navigation system, Neuro Navigator III. We approached the sphenoid sinus mainly via the hemilateral common meatus. The deviation of the nasal septum and sphenoidal septum was carefully evaluated to determine the optimal operating side. We concluded that the hemilateral common meatus route is useful because it is least invasive in endocopic endonasal hypophysectomy. Another route should be taken, however, if hemorrhaging is uncontrollable or the tumor is quite large. Navigation systems are quite effective in executing this operation safely. Angle-dependent navigation system is a good choice for this operation, considering its cost performance.
长期以来，哈代使用显微镜进行的手术一直是治疗垂体腺瘤的标准方法。据报道，一种结合了内窥镜和导航系统的经鼻蝶窦新入路，我们于2000年10月至2003年6月期间，使用该方法对11例垂体病变患者进行了内窥镜经鼻垂体切除术。我们引入了一种角度依赖型导航系统——神经导航仪III。我们主要通过半侧总鼻道进入蝶窦。仔细评估鼻中隔和蝶窦隔的偏差，以确定最佳手术侧。我们得出结论，半侧总鼻道入路是有用的，因为它在内窥镜经鼻垂体切除术中侵袭性最小。然而，如果出血无法控制或肿瘤非常大，则应采用另一种入路。导航系统在安全实施该手术方面非常有效。考虑到性价比，角度依赖型导航系统是该手术的一个不错选择。
