Schaberg Madeleine R, Anand Vijay K, Schwartz Theodore H, Cobb William
Department of Otolaryngology, New York Presbyterian Hospital, Weill Medical College of Cornell University, New York, New York 10021, USA.
Curr Opin Otolaryngol Head Neck Surg. 2010 Feb;18(1):8-14. doi: 10.1097/MOO.0b013e328334db5b.
The transnasal endoscopic approach to the sella turcica is an alternative to the microscopic approach and over the last decade has come into prominence as a new technique. In the present article, we will analyze the current literature on outcomes between the two techniques.
The endoscopic approach to the pituitary has redefined visualization of the sella. The panoramic view afforded by the endoscope is unparalleled as compared with the traditional conical view of the microscope. This technique has been shown to have a statistically significant reduction in operative time and length of hospital stay. There is also a trend toward improved endocrine outcomes and rate of return of visual defects. These two approaches are equally efficacious in oncological outcomes and the complication rates are comparable.
With longer follow-up of this developing field it may be shown that complication rates are decreased, surgical reconstruction is less time consuming, and tumor resection is more complete due to improved visualization in the sellar and parasellar areas. In addition, the use of endoscopes facilitates extended approaches, reaching a myriad of skull base lesions that are suprasellar, retrosellar, and parasellar, which permits visualization beyond the abilities of the microscope.
经鼻内镜入路至蝶鞍是显微镜入路的一种替代方法，在过去十年中作为一种新技术崭露头角。在本文中，我们将分析关于这两种技术疗效的当前文献。
垂体的内镜入路重新定义了蝶鞍的视野。与显微镜传统的锥形视野相比，内镜提供的全景视野无与伦比。该技术已被证明在手术时间和住院时间上有统计学显著减少。在内分泌疗效和视力缺损恢复率方面也有改善趋势。这两种方法在肿瘤学疗效方面同样有效，并发症发生率相当。
随着对这个发展中领域的随访时间延长，可能会显示出并发症发生率降低、手术重建耗时减少，并且由于蝶鞍和鞍旁区域视野改善，肿瘤切除更完整。此外，内镜的使用便于进行扩展入路，能够到达鞍上、鞍后和鞍旁的众多颅底病变，这使得视野超出了显微镜的能力范围。
