Cooke R S, Jones R A
Department of Neurosurgery, Hope Hospital, Salford, UK.
Br J Neurosurg. 1994;8(2):193-6. doi: 10.3109/02688699409027966.
The direct transnasal transsphenoidal approach to the pituitary fossa has been used in our unit since 1987. We describe the procedure and report its use in 48 patients with pituitary lesions. Successful access to the pituitary fossa was made in 46 out of 50 operations (92%). In two cases, repeat transnasal exploration was successfully performed for recurrent tumour 3 and 5 years following an initial trans-nasal exploration. This approach is straightforward, quick and does not require dissection of nasal mucosa or removal of septal cartilage. There was a 5.8% rate of major post-operative complications, and this compares favourably with other routes of access to the pituitary fossa. No long-term nasal, septal or dental complications have occurred, such as may happen with the other routes to the sphenoid sinus and pituitary fossa.
自1987年起，我们科室就采用经鼻直接经蝶窦入路治疗垂体窝病变。我们描述了该手术方法，并报告了其在48例垂体病变患者中的应用情况。50例手术中有46例成功进入垂体窝（成功率为92%）。有2例患者在初次经鼻探查后3年和5年因肿瘤复发再次成功进行了经鼻探查。这种入路操作简单、迅速，无需切开鼻黏膜或切除鼻中隔软骨。术后严重并发症发生率为5.8%，与其他进入垂体窝的途径相比具有优势。未出现长期的鼻腔、鼻中隔或牙齿并发症，而其他进入蝶窦和垂体窝的途径可能会出现此类并发症。
