Liu Jie, Wang Pan, Tang Chao, Jiang Hao-Tian, Zhang Gang, Wu Nan
Department of Neurosurgery, Chongqing General Hospital, Liangjiang, Chongqing 401147, P.R. China.
Exp Ther Med. 2023 Jan 27;25(3):114. doi: 10.3892/etm.2023.11813. eCollection 2023 Mar.
Thanks to the rapid development and progress of endoscopic technology, the endoscopic endonasal transsphenoidal approach has become one of the best surgical methods for resection of sellar and suprasellar tumors. The craniopharyngioma is usually located in the sellar region or suprasellar region, which is suitable for resection through the endoscopic endonasal transsphenoidal approach. The present report describes 21 cases of craniopharyngioma treated by endoscopic endonasal transsphenoidal approach in the Department of Neurosurgery at the Chongqing General Hospital from February 2014 to September 2019. The characteristics of patients and tumors, including clinical symptoms, preoperative magnetic resonance imaging, intraoperative conditions, as well as postoperative and follow-up outcomes were evaluated. The main clinical symptoms were headache in 15 cases, visual deficiency in 13 cases and growth retardation in two cases. All 21 patients with craniopharyngioma underwent endoscopic endonasal transsphenoidal surgery. Of these, 20 patients achieved gross total resection and one case achieved subtotal resection. After surgery, headache symptoms improved in 11 patients without deterioration and the vision of 11 patients improved without deterioration. The primary postoperative complications were pituitary deficiency in eight cases and permanent diabetes insipidus in five cases. The patients were followed up from one to 52 months post-operation. There was no recurrence in all patients during the follow-up period. The endoscopic endonasal transsphenoidal approach is a safe and effective resection for craniopharyngioma. Moreover, the endoscopic endonasal trans-sphenoidal approach is one of the preferred surgical methods for treatment of sellar or suprasellar tumor.
得益于内镜技术的快速发展与进步，经鼻内镜经蝶窦入路已成为切除鞍区和鞍上区肿瘤的最佳手术方法之一。颅咽管瘤通常位于鞍区或鞍上区，适合通过经鼻内镜经蝶窦入路进行切除。本报告描述了2014年2月至2019年9月重庆医科大学附属第一医院神经外科采用经鼻内镜经蝶窦入路治疗的21例颅咽管瘤患者。评估了患者和肿瘤的特征，包括临床症状、术前磁共振成像、术中情况以及术后和随访结果。主要临床症状为头痛15例、视力减退13例、生长发育迟缓2例。21例颅咽管瘤患者均接受了经鼻内镜经蝶窦手术。其中，20例患者实现了肿瘤全切除，1例患者实现了次全切除。术后，11例患者头痛症状改善且无恶化，11例患者视力改善且无恶化。术后主要并发症为垂体功能减退8例、永久性尿崩症5例。患者术后随访1至52个月。随访期间所有患者均无复发。经鼻内镜经蝶窦入路是治疗颅咽管瘤安全有效的手术方法。此外，经鼻内镜经蝶窦入路是治疗鞍区或鞍上区肿瘤的首选手术方法之一。
