[1]陈大瑜　刘　宁　黄麒霖等.海绵窦间隙在侵袭海绵窦垂体腺瘤神经内镜经鼻蝶入路切除术中的应用[J].中国临床神经外科杂志,2021,26(10):747-750.[doi:10.13798/j.issn.1009-153X.2021.10.002]
　CHEN Da-yu,LIU Ning,HUANG Qi-lin,et al.Application of cavernous sinus compartments in endo-scopic transnasal surgery for patients with pituitary adenoma invading cavernous sinus[J].,2021,26(10):747-750.[doi:10.13798/j.issn.1009-153X.2021.10.002]
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海绵窦间隙在侵袭海绵窦垂体腺瘤神经内镜经鼻蝶入路切除术中的应用()
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《中国临床神经外科杂志》[ISSN:1009-153X/CN:42-1603/TN]

卷:
26
期数:
2021年10期
页码:
747-750
栏目:
论著
出版日期:
2021-10-25

文章信息/Info

Title:
Application of cavernous sinus compartments in endo-scopic transnasal surgery for patients with pituitary adenoma invading cavernous sinus
文章编号:
1009-153X（2021）10-0747-04
作者:
陈大瑜　刘　宁　黄麒霖等
作者单位：武汉 430070，中国人民解放军中部战区总医院神经外科（陈大瑜、刘　宁、黄麒霖、秦海林、谢天浩、秦　汉、胡军民、宋　健、姚国杰）
Author(s):
CHEN Da-yu;  LIU Ning;  HUANG Qi-lin;  et al
Department of Neurosurgery, General Hospital, Central Theater Command, PLA, Wuhan 430070, China
关键词:
垂体腺瘤; 海绵窦间隙; 神经内镜; 经鼻蝶入路; 手术
Keywords:
Pituitary adenoma;  Cavernous sinus compartment;  Endoscopic transnasal resection
分类号:
A
DOI:
10.13798/j.issn.1009-153X.2021.10.002
文献标志码:
R 739.41; R 651.1+1
摘要:
目的 探讨海绵窦间隙在侵袭海绵窦垂体腺瘤神经内镜经鼻蝶入路切除术中的应用价值。方法 回顾性分析2017年1月至2020年10月经鼻蝶入路神经内镜手术治疗的15例侵袭海绵窦垂体腺瘤的临床资料。基于颈内动脉的自然走形，把海绵窦分为上、下、后、外侧间隙，术中对不同间隙内肿瘤采用不同切除方法。结果 肿瘤全切除11例，次全切除4例。术后发生脑脊液鼻漏1例，尿崩6例，垂体功能减退危象1例，眼球外展障碍1例，动眼神经麻痹1例。15例术后随访3~36个月；11例肿瘤全切除中，10例无复发，1例无功能垂体腺瘤复发并动态观察；4例次全切除中，2例无进展；2例术后6个月内行伽玛刀治疗。结论 神经内镜下经鼻入路手术切除侵袭海绵窦垂体腺瘤的效果良好，基于颈内动脉的自然走形的海绵窦间隙划分方法为侵袭海绵窦垂体腺瘤的手术治疗提供了新思路。
Abstract:
Objective To investigate the application value of cavernous sinus compartments in endoscopic transnasal resection of pituitary adenomas invading cavernous sinus. Methods A retrospective analysis was performed on the clinical data of 15 patients with pituitary adenoma invading cavernous sinus who underwent endoscopic transnasal resection from January 2017 to October 2020. Based on the natural shape of the internal carotid artery, the cavernous sinus compartments were divided into the upper, lower, posterior and lateral compartments, and different resection methods were used for tumors in different compartments. Results Total tumor resection was achieved in 11 patients and subtotal in 4. After the operation, cerebrospinal fluid rhinorrhea occurred in 1 patient, diabetes insipidus in 6, hypopituitarism crisis in 1, ocular abduction disorder in 1, and oculomotor nerve palsy in 1. The follow up time of 15 patients ranged from 3 months to 36 months. Of 11 patients with total tumor resection, 10 patients had no recurrence, and 1 with non-functioning pituitary adenoma recurred and recieved observation. Of 4 patients with subtotal resection, 2 patients had no progression and 2 received gamma knife treatment within 6 months after the operation. Conclusions Neuroendoscopic transnasal surgical resection is a good treatment method for the patients with pituitary adenoma invading cavernous sinus. The method of dividing the cavernous sinus compartments based on the natural shape of the internal carotid artery provides a new idea for the surgical treatment of pituitary adenomas invading cavernous sinus.

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备注/Memo

备注/Memo:
通讯作者：姚国杰，E-mail：yaoguojie@sina.com
更新日期/Last Update: 1900-01-01