Favier V, Boetto J, Cartier C, Segnarbieux F, Crampette L
Service d'ORL, chirurgie maxillo-faciale et stomatologie, hôpital Gui-de-Chauliac, CHU Montpellier, 34000 Montpellier, France.
Service de neurochirurgie A, hôpital Gui-de-Chauliac, CHU Montpellier, 34000 Montpellier, France.
Eur Ann Otorhinolaryngol Head Neck Dis. 2019 Apr;136(2):131-134. doi: 10.1016/j.anorl.2018.10.005. Epub 2018 Oct 23.
Pituitary surgery is performed via a transsphenoidal approach in the vast majority of cases according to various methods that have changed over the years. A microscopic transseptal approach via a sublabial mucosal incision or a nasal mucosal incision has also been extensively used. An endoscopic transnasal approach was first described in the 1990's, followed by the concept of a microscopic transseptal approach and an endoscopic strictly endonasal approach. We use an entirely endoscopic transseptal transsphenoidal approach via an incision in the nasal mucosa for both access and tumour resection. This procedure has a number of advantages: strictly midline approach to the sella turcica, large operative field, no interference between instruments and a low rate of nasal complications.
在绝大多数情况下，垂体手术是通过经蝶窦入路进行的，多年来其方法不断变化。通过唇下黏膜切口或鼻黏膜切口的显微镜下经鼻中隔入路也被广泛应用。内镜经鼻入路最早在20世纪90年代被描述，随后出现了显微镜下经鼻中隔入路和严格的内镜经鼻入路的概念。我们通过鼻黏膜切口采用完全内镜经鼻中隔经蝶窦入路进行手术入路和肿瘤切除。该手术有许多优点：严格经中线进入蝶鞍，手术视野大，器械之间无干扰，鼻腔并发症发生率低。
