Pinar Ercan, Yuceer Nurullah, Imre Abdulkadir, Guvenc Gonul, Gundogan Onur
From the Departments of *Otorhinolaryngology, and †Neurosurgery, Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey.
J Craniofac Surg. 2015 Jan;26(1):201-5. doi: 10.1097/SCS.0000000000001240.
The objective of this study was to report the efficacy, safety, and outcomes of endoscopic endonasal transsphenoidal techniques for pituitary adenomas.
A retrospective data analysis of 32 patients who underwent endoscopic endonasal transsphenoidal surgery for pituitary adenoma between February 2011 and December 2013 was performed. The patients' demographic data, clinical presentations, radiologic findings, recurrence rates, and complications were analyzed.
There were 14 men and 18 women with age ranging from 23 to 74 years (mean age, 48.6 y). Functioning and nonfunctioning tumors were present in 22 (68.8%) and 10 patients (31.2%), respectively. Among the functioning adenomas, 8 patients (25%) had growth hormone-secreting adenomas, 6 patients (18.8%) had prolactinomas, 5 patients (15.6%) had adrenocorticotropic hormone-secreting adenomas, 2 patients (6.2%) had follicle-stimulating hormone/luteinizing hormone-secreting adenomas, and 1 patient (3.1%) had thyroid-stimulating hormone-secreting adenomas. Of the 32 patients, 20 (62.5%) had pituitary macroadenomas and 12 patients (37.5%) had microadenomas. Total-subtotal tumor resection was achieved in 75% and 45% of the microadenomas and macroadenomas, respectively. Radiologically, 60% of the macroadenomas had suprasellar and carvenous sinus extension. Postoperative cerebrospinal fluid leaks occurred in 3 patients. Two patients developed temporary diabetes insipidus.
Endoscopic transsphenoidal surgery is an effective and safe treatment for most patients with pituitary adenoma and could be considered the first-choice therapy in these patients.
本研究的目的是报告经鼻内镜经蝶窦技术治疗垂体腺瘤的疗效、安全性及结果。
对2011年2月至2013年12月间32例行经鼻内镜经蝶窦垂体腺瘤手术的患者进行回顾性数据分析。分析患者的人口统计学数据、临床表现、影像学检查结果、复发率及并发症。
32例患者中，男性14例，女性18例，年龄23至74岁（平均年龄48.6岁）。功能性肿瘤和无功能性肿瘤分别有22例（68.8%）和10例（31.2%）。在功能性腺瘤中，8例（25%）为生长激素分泌型腺瘤，6例（18.8%）为泌乳素瘤，5例（15.6%）为促肾上腺皮质激素分泌型腺瘤，2例（6.2%）为促卵泡激素/促黄体生成素分泌型腺瘤，1例（3.1%）为促甲状腺激素分泌型腺瘤。32例患者中，20例（62.5%）为垂体大腺瘤，12例（37.5%）为垂体微腺瘤。微腺瘤和大腺瘤的全切除-次全切除率分别为75%和45%。影像学检查显示，60%的大腺瘤有鞍上及海绵窦侵犯。3例患者术后发生脑脊液漏。2例患者出现暂时性尿崩症。
经鼻内镜手术对大多数垂体腺瘤患者是一种有效且安全的治疗方法，可作为这些患者的首选治疗方式。
