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垂体手术的耳鼻喉科考量:内分泌科医生应了解的内容。

Otolaryngology Considerations of Pituitary Surgery: What an Endocrinologist Should Know.

作者信息

Cheng Michael Z, Saraswathula Anirudh, Qureshi Hannan A, Mukherjee Debraj, Rowan Nicholas R

机构信息

Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medicine, Baltimore, MD 21287, USA.

Department of Neurosurgery, Johns Hopkins Medicine, Baltimore, MD 21287, USA.

出版信息

J Endocr Soc. 2023 Apr 27;7(7):bvad058. doi: 10.1210/jendso/bvad058. eCollection 2023 Jun 5.

Abstract

Endoscopic endonasal skull base surgery is the preferred surgical approach for the management of pituitary adenomas. Perioperative management of pituitary lesions requires multidisciplinary care and typically includes a dual surgeon team consisting of a neurosurgeon and an otolaryngologist. The involvement of the otolaryngologist allows for a safe surgical approach with excellent intraoperative visualization of the tumor to enable an effective resection of the tumor by the neurosurgeon. Detection and treatment of sinonasal pathology is essential prior to surgery. Patients may experience sinonasal complaints following endoscopic transsphenoidal surgery, although this is typically temporary. Sinonasal care in the postoperative period can expedite recovery to baseline. Here we discuss the perioperative factors of endoscopic pituitary surgery that endocrinologists should be aware of, ranging from preoperative patient selection and optimization to postoperative care, with a particular emphasis on anatomic and surgical factors.

摘要

鼻内镜下经鼻颅底手术是垂体腺瘤治疗的首选手术方式。垂体病变的围手术期管理需要多学科协作,通常包括由神经外科医生和耳鼻喉科医生组成的双外科医生团队。耳鼻喉科医生的参与使得手术方法安全,术中能很好地观察肿瘤,从而使神经外科医生能够有效地切除肿瘤。手术前鼻窦疾病的检测和治疗至关重要。患者在内镜经蝶窦手术后可能会出现鼻窦相关症状,不过这通常是暂时的。术后鼻窦护理可加快恢复至基线水平。在此,我们讨论内分泌科医生应了解的内镜垂体手术围手术期因素,范围从术前患者选择和优化到术后护理,尤其强调解剖学和手术因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/850c/10259068/d1ed49ed784a/bvad058f1.jpg

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