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[经鼻内镜垂体瘤手术治疗中鼻窦炎的防治]

[Prevention and cure sinusitis complicated by endoscopic transnasal approach in surgical treatment of pituitary adenoma].

作者信息

Yan Bo, Zhang Qiuhang, Lü Haili

机构信息

Department of Otolaryngology-Head and Neck Surgery, Xuanwu Hospital, Capital University of Medical Science, Beijing, 100053, China.

出版信息

Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2010 Apr;24(8):353-5.

Abstract

OBJECTIVE

To recognize the causes, methods of prevention and cure of sinusitis complicated by endoscopic transnasal approach in surgical treatment of pituitary adenomas.

METHOD

The data of 187 patients who underwent surgical treatments of pituitary adenomas through endoscopic transnasal approach were collected, and the surgical complications were analyzed.

RESULT

Endoscopic transnasal transsphenoidal approach were used successfully in 187 cases, twelve cases (6.4%) were suffered from sinusitis complication after surgery. The most frequent sinusitis complication was sphenoiditis, 9 cases (4.8%) were suffered, 2 cases (1.1%) were suffered from ethmoidal sinusitis, 1 case (0.5%) was suffered from maxillary sinusitis. Ten cases were treated with correspond medication in clinic. Two cases were ineffective with expectant treatment, and cured by second endoscopic sinusitis operation at last.

CONCLUSION

Endoscopic transnasal transsphenoidal approach offered a simple and rapid access to the sella, and also, it is a safe, valuable and efficient procedure for removing pituitary adenomas. It was obviously that timely accurate diagnosis for the sinusitis complication and comprehensive perioperative management may lead to less incidence of postoperative sinusitis complication in surgical treatment of pituitary adenomas through endoscopic transnasal approach, increase the achievement rate and improve survival quality obviously.

摘要

目的

认识垂体腺瘤经鼻内镜手术治疗中并发鼻窦炎的原因、防治方法。

方法

收集187例行经鼻内镜垂体腺瘤手术治疗患者的数据,分析手术并发症。

结果

187例均成功采用经鼻内镜经蝶窦入路手术,术后12例(6.4%)发生鼻窦炎并发症。最常见的鼻窦炎并发症是蝶窦炎,9例(4.8%)发生,筛窦炎2例(1.1%),上颌窦炎1例(0.5%)。10例在门诊给予相应药物治疗。2例保守治疗无效,最终经二次鼻内镜鼻窦手术治愈。

结论

经鼻内镜经蝶窦入路为鞍区提供了一种简单快捷的途径,也是一种安全、有价值且有效的垂体腺瘤切除手术。显然,对于鼻窦炎并发症及时准确诊断并进行全面的围手术期管理,可降低经鼻内镜垂体腺瘤手术治疗后鼻窦炎并发症的发生率,显著提高成功率并改善生存质量。

相似文献

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Transsphenoidal pseudocapsule-based extracapsular resection for pituitary adenomas.经蝶窦基于假包膜的垂体腺瘤囊外切除术。
Acta Neurochir (Wien). 2011 Apr;153(4):799-806. doi: 10.1007/s00701-011-0961-1. Epub 2011 Feb 19.

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