Sandoval-Sánchez J H, Flores-Cárdenas F, Vargas-Frutos M C, Páez-Ontiveros J M
Departamentos de Neurocirugía, Unidad Médica de Alta Especialidad, Hospital de Especialidades. Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, México.
Neurocirugia (Astur). 2007 Dec;18(6):485-91.
To describe the frequency of complications and complaints caused by direct endonasal transsphenoidal approach used in the resection of pituitary adenomas.
In a retrospective way, we review patients' records with pituitary adenomas, operated by means of direct endonasal transsphenoidal approach, between August 2003 and December 2004. We recollected information about operative and postoperative complications, besides complaints registered in patients' records.
41 patients were included, 23 (56.1%) males and 18 (43.9%) females, with a mean age of 47.7 -/+16.8 years. Operative complications were intrasellar hemorrhage in three patients (7.3%), hypertension in two (4.9%) and cerebrospinal fluid fistula in one (2.4%). On the other hand, postoperative complications were diabetes insipidus (24.4%) in ten cases, anterior pituitary insufficiency (4.9%) in two and sinusitis (2.4%) in one. Nasal congestion was the most common complaint (31.7%) in thirteen patients.
Supported in our results, the direct endonasal transsphenoidal approach tends to present mainly fewer nasal complications and complaints, and in the future it could be considered like the preferred approach for resection of pituitary adenomas.
描述经鼻蝶窦直接入路切除垂体腺瘤所致并发症及不适的发生率。
我们以回顾性方式，查阅了2003年8月至2004年12月间采用经鼻蝶窦直接入路手术的垂体腺瘤患者的病历。除了病历中记录的不适外，我们还收集了有关手术及术后并发症的信息。
纳入41例患者，其中男性23例（56.1%），女性18例（43.9%），平均年龄47.7±16.8岁。手术并发症包括3例（7.3%）鞍内出血、2例（4.9%）高血压和1例（2.4%）脑脊液漏。另一方面，术后并发症包括10例（24.4%）尿崩症、2例（4.9%）垂体前叶功能减退和1例（2.4%）鼻窦炎。鼻塞是13例患者中最常见的不适（31.7%）。
根据我们的结果，经鼻蝶窦直接入路往往主要出现较少的鼻腔并发症及不适，未来可考虑将其作为垂体腺瘤切除的首选入路。
