ABSTRACT
Objective To analysis the therapeutic effect of microsurgery through single-nostril transsphenoidal approach on pituitary adenomas and to study the surgical skill and postoperative complications about microsurgery for pituitary adenomas.Methods The clinical manifestations,pathological type, removal percentage,postoperative complications and follow-up data of 241 cases with pituitary ademoma by microsurgery through single-nostril transsphenoidal approach were analysed retrospectively.Results 171(7 1%)cases were achieved total tumor removal,28(11.6%)cases were achieved subtotal tumor removal,26(10.7%)cases were achieved most tumor removal and 16(6.6%)cases were achieved partial tumor removal.Most of patients achieved better results,however there were 38(15.8%)eases with diabetes insipidus,12(4.9%)cases with transient worse sight,4(1.6%)cases with cerebrospinal fluid leakage,2(0.8%)cases with oculomotor paralysis,and no death.The postoperative complications were cured and outcome was considered as good.The follow-up period was 1-36 months in 241 patients and the clinical symptoms were improved by different degrees.Conclusion Pituitary adenomas can be treated by microsurgery through single-nostril transsphenoidal approach due to the time of operation shorten,the postoperative complications.
ABSTRACT
Objective To provide the anatomical data for single-nostril transsphenoidal microsurgery for pituitary adenoma.Methods Microanatomic structures were observed and measured in 20 cadaveric a- dults heads.Results(1)The diaphragmal opering was 5 mm or greater broad in 90%.The mean thick- ness of the diaphragma sellae was (0.18?0.08)mm.(2) A sphenoid sinus with complete pneumatization was named as all-sellae type,its percentage in all specimens was 85%,85% sphenoid sinus had middle sep- tum of which only 18.8% located in the medial sagital section.(3)The meant thickness of the sellar floor was (0.81?0.34) mm,70% of which were not more than 1 mm.Of the sellar floors,that the shape was flatness reach 15%.(4) The relationship between ICA and sphenoid sinus had two aspects,one was to be mutually apart (55%),the other was to communicate (45%),which formers carinae on the lateral wall of the sphe- noid sinus,espeially in the superior surface of posterior part.The relationship between optic nerve and sphe- noid sinus,one was to be mutually apart (27.5%),the other was to communicate (72.5% ),which formers carinae on the lateral wall of the sphenoid sinus,especially in the superior surface of anterior part.(5) Three main types of the intercavernous sinus were the anterior intercavernous sinus,present in 80%,the inferior in- tercavenous sinus (25%),and the posterior intercavenous sinus (15%).Conclusion The knowledge of the anatomy of the sellar region and sphenoid sinus is helpful to safe operation in the single-nostril transsphe- noidal approach for pituitary,adenoma microsurgery.