鼻内镜下单鼻孔经鼻蝶垂体瘤切除术中鼻腔结构的保护

Protection of the nasal structures in the single nostril transnasal-transsphenoidal nasal endoscopic surgery for pituitary tumor

摘要:

目的 总结鼻内镜下单鼻孔经鼻蝶垂体瘤切除术中鼻腔结构的保护方法。方法 采用鼻内镜下单鼻孔经鼻腔蝶窦入路切除垂体瘤9例，术中注意保护鼻腔结构，从较宽的一侧鼻腔入路，仅切除术侧中鼻甲后端，开放蝶窦前壁和鞍底后切除肿瘤，然后仅填塞蝶窦腔和术侧鼻腔上部。结果 术中内镜下完全切除9例肿瘤，术后临床症状和内分泌检查结果均改善，患者无明显鼻腔疼痛及头痛不适，鼻腔结构形态良好，未出现垂体功能障碍、颅内和鼻部并发症。结论 鼻内镜下单鼻孔经鼻腔蝶窦垂体瘤切除术在切除肿瘤的前提下注意鼻腔结构的保护，能减少创伤，术后恢复快、并发症少。

Abstract:

【Objective】 To summarize the protective methods of nasal structures in the single nostril transnasal-transsphenoidal nasal endoscopic surgery for pituitary tumors. 【Methods】 9 cases of pituitary tumors undergone single nostril transnasal-transsphenoidal nasal endoscopic surgery. In order to protect the nasal structures, the approach was begun through the wide side of the nasal cavity, and only the posterior extremity of middle nasal concha was removed. Then the anterior wall of the sphenoidal sinus and sellar floor was opened, after that the tumors were removed. Finally, the sphenoidal cavity and superior part of the operational nasal cavity was packed. 【Results】 Pituitary tumors in 9 patients were resected completely via the single nostril transnasal-transsphenoidal nasal endoscopic surgery. Postoperative clinical symptoms and endocrine examination results had been improved. Patients had no obvious nasal pain or headache symptom, and the nasal configuration was well, with no pituitary dysfunction or intracranial complications or nasal complications. 【Conclusion】 Protection of the nasal structures in the single nostril transnasal-transsphenoidal nasal endoscopic surgery for pituitary tumors can reduce the surgical trauma, and the protective method allows faster postoperative recovery and less complications.