Microsurgical Treatment for Pituitary Adenoma via Single-nostril Transsphenoidal Approach
10.3969/j.issn.1000-8179.2010.05.016
- VernacularTitle:单鼻孔直接经蝶窦入路显微手术治疗垂体腺瘤
- Author:
Hengzhu ZHANG
;
Xian ZHANG
;
Yongkang WU
;
Lun DUN
;
Lei SHE
;
Xiaodong WANG
;
Xueqiang SHI
;
Cunlin XU
- Publication Type:Journal Article
- Keywords:
Single-nostril;
Transsphenoid approach;
Microsurgery;
Pituitary adenoma
- From:
Chinese Journal of Clinical Oncology
2010;37(5):289-292
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To explore the effect of single-nostril transsphenoidal approach on pituitary adenoma. Methods: We retrospectively analyzed 46 cases of pituitary tumors treated with single-nostril transsphenoidal approach and the effects and complications of surgery.Dunng the surgery,a nasal speculum was inserted through right nostril slowly towards the anterior wall of sphenoid sinus.A nasal mucosa incision of about 1.5cm was made in the right nasal cavity at the level of the middle nasal turbinate.With a fracture of the bony septum,a space was developed between the bilateral nasal mucosa and bony septum to the sphenoid sinus.Then,the face of the sphenoid sinus was exposed.The remainder of the bony septum,the anterior sphenoid sinus wall,and the sphenoid mucosa were removed.The antenor sphenoidotomy should be less than 1.5cm wide.After confirming the tumor by dural puncture,a cross incision of dura was made and the tumor was removed.The saddle was usually Collapsed and visible after total tumor removal.When the tumor was resected,sevaral gelatin sponges were stuffed into the Surgical cavity to stop bleeding. Results: Thirty-four cases had total resection and 12 cases had subtotal resection.No deaths or disability occurred.Hormone levels in almost all patients were improved.Seventeen cases had a sign of diabetes insipidus.Electrolyte disturbance occuwed in 5 cases.NO postoperative cerebrospinal fluid rhinorrhea was observed. Conclusion: Single-nostril transsphenoidal approach has many advantages in treating pituitary adenomas such as simplified approach,brief technology and high security.
