摘要
目的 评价神经导航系统在垂体瘤显微手术中的应用。方法 在21例垂体瘤手术中，应用StealthStation神经导航系统指导手术操作，其中17例行经蝶手术，3例行扩大前中颅底硬膜外入路，1例行扩大前颅底硬膜外入路＋经蝶手术。神经导航术中定位中线结构、蝶窦前壁、鞍底、以及海绵窦、颈内动脉、斜坡等，并用以判断肿瘤切除程度。结果 21例平均坐标误差为1．14～3．91mm平均1．63mm；预期准确性为1．54～4．82mm平均2．72mm。21例垂体瘤全切14例，次全切除5例，大部切除2例。术后10例出现一过性尿量增多，1例下视丘损伤，无脑脊液漏和颅内感染，无手术死亡。结论 对一些巨大、复发或解剖定位结构不清的垂体瘤进行手术时，神经导航提供实时三维定位，有助于提高肿瘤切除率，减少手术并发症。
Objective To evaluate the effectiveness of neuronavigator-guided microsurgery for the resection of pituitary adenomas． Method 21 patients with pituitary adenomas underwent microsurgery including transsphenoidal approach in 17 extended anterior－middle-fossa extradural approach in 3 and extended anterior-fossa extradural approach combined with transsphenoidal approach in 1 in which StealthStation neuronavigator was used to localize the anatomic midline anterior-wall of sphenoidal sinus floor of sella cavernous sinus internal carotid artery clivus and to estimate the extent of lesion-resection． Result Mean fiducial error and predicted accuracy in 10 cm were ranged from 1．14 to 3．91mmmean 1．63mm and 1．54 to 4．82mmmean 2．72 respectively． Total tumor removal was achieved in 14 patients and subtotal removal in 5． Postoperatively transient diabetes insipidus and hypothalamic injury were found in 10 and 1 cases respectively． There was no cerebrospinal fluid leakage meningitis and death． Conclusion During pituitary microsurgery StealthStation neuronavigator provides realtime localization with three-dimensional information expecially for some giant or recurrent tumors or tumors with confused anatomic structures． It is quite useful for the total tumor removal and reducing the surgical complications．
出处
《中国微侵袭神经外科杂志》
CAS
2001年第2期65-68,共4页
Chinese Journal of Minimally Invasive Neurosurgery
