Farrell Christopher J, Nyquist Gurston G, Farag Alexander A, Rosen Marc R, Evans James J
Department of Neurological Surgery, Thomas Jefferson University, 909 Walnut Street, 2nd Floor, Philadelphia, PA 19107, USA.
Department of Otolaryngology, Thomas Jefferson University, Philadelphia, PA, USA.
Otolaryngol Clin North Am. 2016 Feb;49(1):95-106. doi: 10.1016/j.otc.2015.09.005.
Since the description of a transnasal approach for treatment of pituitary tumors, transsphenoidal surgery has undergone continuous development. Hirsch developed a lateral endonasal approach before simplifying it to a transseptal approach. Cushing approached pituitary tumors using a transsphenoidal approach but transitioned to the transcranial route. Transsphenoidal surgery was not "rediscovered" until Hardy introduced the surgical microscope. An endoscopic transsphenoidal approach for pituitary tumors has been reported and further advanced. We describe the principles of pituitary surgery including the key elements of surgical decision making and discuss the technical nuances distinguishing the endoscopic from the microscopic approach.
自从经鼻入路治疗垂体瘤的方法被描述以来，经蝶窦手术不断发展。赫希在将其简化为经鼻中隔入路之前，先开发了一种鼻侧入路。库欣采用经蝶窦入路治疗垂体瘤，但后来转向了经颅入路。直到哈代引入手术显微镜，经蝶窦手术才被“重新发现”。经鼻内镜垂体瘤手术已被报道并进一步发展。我们描述了垂体手术的原则，包括手术决策的关键要素，并讨论了区分内镜手术与显微镜手术的技术细微差别。
