Kalinin P L, Sharipov O I, Shkarubo A N, Fomichev D V, Kutin M A, Alekseev S N, Kadashev B A, Iakovlev S B, Dorokhov P S, Bukharin E Iu, Kurnosov A B, Popugaev K A
Zh Vopr Neirokhir Im N N Burdenko. 2013;77(6):28-37; discussion 38.
Endoscopic endonasal transsphenoidal approach (EETA) is an effective and relatively safe to remove pituitary adenomas and other sellar region tumors. One of the most serious complications of transsphenoidal surgery is damage to the cavernous segment of the internal carotid artery, which by different authors occurs at 0 to 3.8%. In the period from 2005 to March 2013 in Burdenko neurosurgical institute 3,000 patients with pituitary adenomas were operated by standard endoscopic transsphenoidal approach. Damage to the internal carotid artery (ICA) occurred in 4 patients, which amounted to 0.13%. To all patients with damage of the ICA angiography was performed in which identified one case of occlusion of the ICA and three cases of false aneurysm formation. Three patients underwent endovascular treatment. Damage to the internal carotid artery may be associated with the wrong orientation in the surgical wound, or excessively aggressive manipulations in the cavernous sinus. Damage to the cavernous segment of the ICA during transsphenoidal surgery is a rare but potentially fatal complication. Extremely important is the correct localization of the middle line and ICA using navigation systems and Doppler ultrasound.
鼻内镜下经蝶窦入路（EETA）是切除垂体腺瘤和其他鞍区肿瘤的一种有效且相对安全的方法。经蝶窦手术最严重的并发症之一是损伤颈内动脉海绵窦段，不同作者报道的发生率为0%至3.8%。2005年至2013年3月期间，布尔坚科神经外科研究所对3000例垂体腺瘤患者采用标准鼻内镜经蝶窦入路进行手术。4例患者发生颈内动脉（ICA）损伤，发生率为0.13%。对所有ICA损伤患者均进行了血管造影，其中发现1例ICA闭塞和3例假性动脉瘤形成。3例患者接受了血管内治疗。颈内动脉损伤可能与手术切口定位错误或在海绵窦内过度激进的操作有关。经蝶窦手术中ICA海绵窦段损伤是一种罕见但可能致命的并发症。使用导航系统和多普勒超声正确定位中线和ICA极其重要。
