Urquhart A C, Bersalona F B, Ejercito V S, Holt J J
Department of Otolaryngology/Head and Neck Surgery, Marshfield Clinic, WI 54449, USA.
Otolaryngol Head Neck Surg. 1996 Jul;115(1):64-9. doi: 10.1016/S0194-5998(96)70138-9.
Transseptal transsphenoidal approach to the pituitary fossa is a well-described and effective procedure. This article relates our experience with this procedure with specific emphasis on the nasal septum, both before and after surgery. It has been our experience that this surgery has minimal local complications in the nose and it would appear to improve septal alignment with subjective improvement in nasal function as reported by the patient. A total of 55 patients undergoing a sublabial transseptal transsphenoidal approach to the pituitary fossa were included in this study. All other approaches to the pituitary gland were excluded. Visual changes and headaches were the most common presenting symptoms, occurring alone or in combination in 28 (51%) patients. Twelve (22%) patients reported symptoms of nasal obstruction before surgery and only one (2%) after surgery. A moderately or severely deviated septum was noted in 30 (54%) patients before surgery and 4 (7%) patients after surgery. The septum was straight in 21 (38%) patients before the procedure and 49 (89%) patients after the surgery. Sinusitis developed in two patients, and one patient subsequently required surgery. No synechiae or septal perforations were noted.
经鼻中隔经蝶窦入路至垂体窝是一种描述详尽且有效的手术方法。本文讲述了我们在该手术方面的经验，特别着重于手术前后鼻中隔的情况。我们的经验是，该手术在鼻腔的局部并发症极少，而且似乎能改善鼻中隔的对线情况，患者也报告说鼻腔功能有主观改善。本研究纳入了55例行经唇下经鼻中隔经蝶窦入路至垂体窝手术的患者。所有其他垂体手术入路均被排除。视力改变和头痛是最常见的首发症状，单独或合并出现于28例（51%）患者中。12例（22%）患者术前报告有鼻塞症状，术后仅1例（2%）有此症状。术前30例（54%）患者鼻中隔有中度或重度偏曲，术后4例（7%）有此情况。术前21例（38%）患者鼻中隔是直的，术后49例（89%）患者鼻中隔变直。2例患者发生鼻窦炎，其中1例随后需要手术治疗。未发现粘连或鼻中隔穿孔情况。
