Mattox D E, Carson B S
Skull Base Surg. 1991;1(3):177-82. doi: 10.1055/s-2008-1057003.
The sublabial transseptal transsphenoidal approach provides excellent exposure for pituitary surgery in adults. However, sellar lesions in children are more difficult to approach because of the smaller size of the pyramidal aperture and because of the limited pneumatization of the sella. We resurrected the transpalatal transsphenoidal approach for the treatment of sellar lesions in three children (one adenoma and two cystic craniopharyngiomas). The advantages of this approach were a short working distance and a wide exposure that permitted extensive drilling of the poorly pneumatized sphenoid bone under direct vision. The technique successfully provided exposure for management of the sellar pathology in all three cases and resulted in no nasal or palatal defects.
唇下经鼻中隔经蝶窦入路为成人垂体手术提供了极佳的暴露。然而，由于儿童蝶骨孔尺寸较小且蝶鞍气化有限，儿童鞍区病变更难处理。我们采用经腭经蝶窦入路治疗了3例儿童鞍区病变（1例腺瘤和2例囊性颅咽管瘤）。该入路的优点是操作距离短、暴露范围广，可在直视下对气化不良的蝶骨进行广泛钻孔。该技术成功为所有3例患者的鞍区病变处理提供了暴露，且未导致鼻腔或腭部缺损。
