[1]周全,肖绍文,谭源福,等.神经导航在经蝶入路垂体腺瘤切除术中的应用[J].中国微创外科杂志,2007,07(7):649-650.
　Zhou Quan,Xiao Shaowen,Tan Yuanfu,et al.Clinical evaluation of neuronavigation in transsphenoidal approach microneurosurgical resection of pituitary adenoma[J].Chinese Journal of Minimally Invasive Surgery,2007,07(7):649-650.
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神经导航在经蝶入路垂体腺瘤切除术中的应用()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
07
期数:
2007年7期
页码:
649-650
栏目:
出版日期:
2007-07-20

文章信息/Info

Title:
Clinical evaluation of neuronavigation in transsphenoidal approach microneurosurgical resection of pituitary adenoma
作者:
周全; 肖绍文; 谭源福; 张超元; 罗昱
广西医科大学第一附属医院神经外科，南宁530021
Author(s):
Zhou Quan;  Xiao Shaowen;  Tan Yuanfu;  et al.
Department of Neurosurgery, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China
关键词:
神经外科导航; 垂体腺瘤; 经蝶入路; 显微手术
Keywords:
Neuronavigation; Pituitary adenoma; Transsphenoidal apporoach; Microneurosurgery
分类号:
R739.41
文献标志码:
A
摘要:
目的探讨神经外科导航系统在经蝶入路垂体腺瘤切除术中的作用。方法在12例经蝶入路垂体腺瘤切除术前，采用CT或MRI无间隙扫描,输入导航系统进行三维重建, 注册。术中应用神经导航实时定位中线结构、蝶窦前壁、鞍底确定入路, 定位海绵窦、颈内动脉等重要结构以防止损伤,术后判断肿瘤切除程度。结果12例平均坐标误差(2.13±0.94) mm，靶点定位误差<2 mm。手术时间70～90 min，平均85 min。12例垂体腺瘤全切9例,次全切除3例。一过性尿量增多2例,脑脊液鼻漏1例。术后无明显神经功能障碍。12例均于术后3～6个月复查头颅增强MRI,1例垂体腺瘤残瘤增大，行γ刀治疗。结论神经外科导航系统在经蝶入路垂体腺瘤切除术中准确，安全，便捷，手术全切率高，并发症少。
Abstract:
ObjectiveTo explore the effectiveness and significance of neuronavigation in transsphenoidal approach microneurosurgical treatment of pituitary adenoma.MethodsA total of 12 patients with pituitary adenomas underwent transsphenoidal surgery. Before the surgery a continuous CT or MRI scanning was adopted, and then the data were inputted into the neuronavigation system for 3D reconstruction and registration. During the surgery, realtime positioning of the anatomic midline, the anterior wall of the sphenoidal sinus, and the floor of the sella turcica was employed by using the neuronavigation system, as well as the identification of the cavernous sinus and the internal carotid artery to avoid unexpected injury. The extent of tumor resection was assessed postoperatively.ResultsThe mean fiducial error was 2.13±0.94 mm, and the accuracy of targets was < 2 mm. The operative time was 70~90 min (mean, 85 min). A total tumor resection was achieved in 9 patients and a subtotal removal, in 3. Transient polyuria happened in 2 cases, and cerebrospinal rhinorrhea was seen in 1 case. The patients’ nerve functions were well preserved. A MRI reexamination was given in all the 12 patients at 3~6 months after operation. Enlargement of residual tumor was identified in 1 patient, and was treated with γknife.ConclusionsThere are obvious advantages for neuronavigation in transsphenoidal approach microneurosurgical resection of pituitary adenoma. Neuronavigation is accurate, safe, and simple in neurosurgeical operations. It facilitates total resection of intracranial lesions with less operative complications.

参考文献/References:

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更新日期/Last Update: 2013-12-09