The Clinical Study On The Pituitary Tumor With Visial Dysfunction Through Transsphenoidal Approach

[Purpose] Pituitary tumor is the first disease incidence in the sellar tumors, optic nerves and optic chiasm are upper to sella turcica. Usually the change of the acuity of vision and campus visualis is clinically the first occuring symptom in the patients with pituitary tumor (124/180) .At first the pituitary tumor grows in bottom of the anterior lobe of pituitary gland . Gradually the body of the tumor expanding and the remainds of the normal pituitary gland stick to the sellae diaphragma. The normal remainding pituitary gland is ofen fistly cut when we cut open the sellae diaphragma to take out tumor from the upper approach. However transsphenoidal approach can reserve the remaining normal pituitary gland as far as possible. The blood of the chiasma opticum area is supplied from artery superior hypophysial artery of cervical internal carotid, latero-artery of chiasm opticum, inferior hypophysial artery and the funnel artery of posterior communicating artery. Because all of them are in the both sides of chiasma opticum or below it, these arteries can get more protection through transsphenoidal approach.There are two main viewpoints to explain the visual disfunction caused by pituitary tumor recently: (l)the tumor compresses directly; (2) the tumor affects the blood supply of the optic chiasm area. Because the studies about affecting factors are relative not many,the research of overall multiplicities has not been worked. This study explores the possible multiple affecting factors that visual disfuction cuased by transsphenoidal approach, discussing the possible...