A Clinical Study Of Pituitary Adenoma Resection By Trans-single Nostril Transsphenoidal Approach

Backgound:Pituitary tumor is the third popular benign intracranial neoplasma. Treatments for pituitary tumors include drugs,radiotherapy and surgical measures.The drug and radiotherapies have been adjunctive therapies.The most effective treatment is still surgical resection.The traditional transcranial surgical approach has been gradually substituted by microscopy transsphenoidal approach.Objectives:Transsphenoidal microsurgery has become a major approach for removal of pituitary adenomas.This article summarizes our experience on 103 patients and discusses some relevant problems,including the adenoma formation mechanism, surgery indications,surgery skill,the factor of resection proportion,management of complications,hoping to improve the successful rate of the operation.Results:All patients underwent operations successfully without fatality.All patients had their tumor removed successfully.Most patients' hormone secretion fell back to normal state.Most patients gained improving after operation.81 cases were excised totally.17 cases were excised subtotally.5 cases were excised partly.Cerebrospinal fluid rhinorrhea lay in 7 patients.12 patients suffered from diabetes insipidus.1 patients happened nasal cavity bleeding.Conclusion:The direct transnasal transsphenoidal approach is an effective method that can shorten the operation time and reduce the morbidity of complications.It needs delicate operation implements and advanced equipments.For the pituitary adenomas invading into the cavernous sinus,the surgeons should have experience because they cannot see some part of the tumors.With the development of endoscope, neuronavigation,intraoperative imaging monitoring,the operation will become more maturity.Transsphenoidal microsurgery is a safe,simple minimally invasive and effective procedure for pituitary tumors.