Haguenauer J P, Goutelle A
Ann Otolaryngol Chir Cervicofac. 1981;98(4-5):207-12.
The authors report on a series of 188 patients operated upon for pituitary tumour. Since 12 operations were performed because of local recurrence, the total number of operations was 200 : 27 by the intracranial route and 173 by the naso-sphenoidal route. Four deaths (17%) followed surgery by the former route and three (1.8%) by the latter route. During the decade under review surgical indications have decreased for large tumours belatedly diagnosed and increased for micro-adenomas giving rise to endocrine symptoms only, notably prolactin-secreting adenomas. Improved knowledge of histopathology has resulted in the classification being altered : the conventional division into eosinophilic and chromophobe adenomas has been abandoned to be replaced by cellular types corresponding to the various hormone-producing and functional adenomas. Also a new type has appeared : oncocytoma. Secreting adenomas generally have a better prognosis than non-secreting adenomas, would it be only because they are smaller. Technical advances in operations almost exclusively performed nowadays by the naso-sphenoidal route have improved the results with regard to sight. Sight is now improved in 70.5% of the cases and completely restored in 32.4%.
作者报告了一系列188例接受垂体肿瘤手术的患者。由于因局部复发进行了12次手术，手术总数为200次：经颅内途径27次，经鼻蝶窦途径173次。前一种途径手术后有4例死亡（17%），后一种途径有3例死亡（1.8%）。在审查的十年中，对于诊断较晚的大肿瘤，手术指征有所减少，而对于仅引起内分泌症状的微腺瘤，特别是分泌催乳素的腺瘤，手术指征有所增加。对组织病理学认识的提高导致了分类的改变：传统的分为嗜酸性和嫌色性腺瘤的分类已被放弃，取而代之的是与各种产生激素的功能性腺瘤相对应的细胞类型。此外，还出现了一种新类型：嗜酸性细胞瘤。分泌性腺瘤的预后通常比非分泌性腺瘤好，这仅仅是因为它们较小。如今几乎完全通过鼻蝶窦途径进行的手术技术进步改善了视力方面的结果。现在70.5%的病例视力得到改善，32.4%的病例视力完全恢复。
