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.
CONCLUSIONS: 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. OBJECTIVES: 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. METHODS: Between January 2007 and January 2012, 30 patients with sellar tumors beyond the sellar turcica underwent surgery using the endoscopic endonasal transsphenoidal approach. RESULTS: 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.
结论: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。 目的: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。 方法: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。 结果: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。
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