Song Yexun, Li Heqing, Liu Huowang, Li Wei, Zhang Xiaowei, Guo Lian, Tan Guolin
Department of Otolaryngology-Head Neck Surgery, Third Xiangya Hospital of Central South University , Changsha, Hunan.
Acta Otolaryngol. 2014 Mar;134(3):326-30. doi: 10.3109/00016489.2013.857785. Epub 2013 Nov 21.
The endoscopic endonasal transsphenoidal approach can be a choice for sellar tumors beyond the sellar turcica, but it is necessary to make the choice carefully because of the severe surgical risks.
To summarize our experience of removal of sellar tumors beyond the sellar turcica via the endoscopic endonasal transsphenoidal approach and to evaluate the surgical efficacy and complications.
Between January 2007 and January 2012, 30 patients with sellar tumors beyond the sellar turcica underwent surgery using the endoscopic endonasal transsphenoidal approach.
Postoperative pathological examination demonstrated that pituitary adenoma occurred in 22 patients, craniopharyngioma in 5, and meningioma in 3. Total removal was achieved in 21 patients (70.0%) and subtotal removal was achieved in 8 patients (26.7%). After the surgery, cerebrospinal fluid leakage occurred in 3 patients, temporary diabetes insipidus occurred in 25 patients and persistent diabetes insipidus in 4 patients, intracranial infection occurred in 1 patient, frontal subdural effusion occurred in 1 patient, sinusitis occurred in 2 patients, epistaxis occurred in 3 patients, and 1 patient with a huge pituitary adenoma died of hypothalamic failure related to the operation.
经鼻内镜经蝶窦入路可作为治疗超出蝶鞍的鞍区肿瘤的一种选择，但由于手术风险高，必须谨慎选择。
总结经鼻内镜经蝶窦入路切除超出蝶鞍的鞍区肿瘤的经验，并评估手术疗效及并发症。
2007年1月至2012年1月，30例超出蝶鞍的鞍区肿瘤患者采用经鼻内镜经蝶窦入路进行手术。
术后病理检查显示，垂体腺瘤22例，颅咽管瘤5例，脑膜瘤3例。21例（70.0%）实现全切除，8例（26.7%）实现次全切除。术后，3例发生脑脊液漏，25例发生暂时性尿崩症，4例发生持续性尿崩症；1例发生颅内感染，1例发生额部硬膜下积液，2例发生鼻窦炎，3例发生鼻出血，1例巨大垂体腺瘤患者死于与手术相关的下丘脑功能衰竭。
