论文部分内容阅读
目的探讨一种可一次全切巨大型侵袭性垂体腺瘤的手术入路,并在临床上应用以验证其实际意义。方法采用15例经福尔马林固定的国人成人头颅湿标本共30侧,模拟额颞眶颧手术入路并逐步对相关的解剖标志进行详细地显微解剖。结合该区域的显微解剖,笔者回顾性总结了近几年收治的采用额颞眶颧入路治疗5例巨大型侵袭性垂体腺瘤的临床资料。结果在硬膜下阶段,根据垂体腺瘤生长的不同方向,可从多个间隙切除肿瘤。联合经硬膜外的海绵窦外侧壁入路可达到一次全切巨大型侵袭性垂体腺瘤的目的。5例巨大型侵袭性垂体腺瘤中,3例全切除,1例为次全切除,1例大部分切除。结论巨大型侵袭性垂体腺瘤可采用额颞眶颧入路进行手术治疗,根据需要可对该入路进行适当裁剪。
Objective To discuss a surgical approach that can completely resect huge invasive pituitary adenoma and apply it clinically to verify its practical significance. Methods 15 formalin-fixed adult human cranial wet specimens of 30 sides were used to simulate the frontotemporal orbital zygomatic approach and to gradually dissect the relevant anatomical landmarks. Combined with the microdissection of the region, the author retrospectively reviewed the clinical data of five cases of giant invasive pituitary adenomas treated with frontotemporal and zygomatic approach in recent years. Results In the subdural phase, tumors can be resected from multiple gaps depending on the direction of pituitary adenoma growth. Combination of the epidural cavernous sinus lateral wall approach can reach a complete removal of huge invasive pituitary adenoma purpose. In 5 cases of giant invasive pituitary adenomas, 3 cases were totally resected, 1 case was subtotal resection and 1 case was mostly resected. Conclusion Large invasive pituitary adenomas can be surgically treated with frontotemporal or zygomatic approach, and the approach can be properly tailored according to the needs.