Fan Jun, Peng Yuping, Qi Songtao, Pan Jun, Lu Yuntao
Department of Neurosurgery, Nanfang Hospital, Southern Medial University, Guangzhou 510515, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2012 Sep;32(9):1297-300.
To study the clinical value of the whole-course endoscopic extended transsphenoidal approach assisted by neuronavigation in surgical resection of complex sphenoclival lesions.
Image reconstruction and registration were performed for 15 patients with complex sphenoclival lesions using the neuronavigation system, and the bilateral nasal extended transsphenoidal approach was adopted to remove the lesions with a whole-course endoscopic procedure.
Postoperative pathological examination reported pituitary adenomas in 7 cases, chordomas in 5 cases, and cavernous angiomas in 3 cases. Total removal of the lesions was achieved in 10 cases, subtotal removal in 4 cases, and partial removal in 1 case. Transient polyuria occurred in 3 cases and 2 patients experienced temporary cerebrospinal rhinorrhea. No death occurred in these cases after the operation. During the follow-up ranging from 3 to 26 months, only 2 patients with partial lesion removal showed recurrence and received subsequent radiotherapy.
The combination of whole-course endoscopic technique and neuronavigation can help improve the surgical outcomes and reduce complications of complex sphenoclival lesion removal via the extended transsphenoidal approach.
探讨神经导航辅助下全程内镜扩大经蝶入路在复杂蝶鞍斜坡区病变手术切除中的临床价值。
对15例复杂蝶鞍斜坡区病变患者应用神经导航系统进行图像重建与注册，采用双侧鼻腔扩大经蝶入路，通过全程内镜手术切除病变。
术后病理检查报告垂体腺瘤7例，脊索瘤5例，海绵状血管瘤3例。病变全切10例，次全切4例，部分切除1例。3例出现短暂性多尿，2例出现暂时性脑脊液鼻漏。术后无死亡病例。随访3至26个月，仅1例部分切除病变的患者复发，随后接受了放疗。
全程内镜技术与神经导航相结合有助于提高扩大经蝶入路切除复杂蝶鞍斜坡区病变的手术效果并减少并发症。
