Tran-single nostril-sphenoid approach for pituitary adenomas in patients with sphenoid sinus dysplasta through neuronavigation system:a report of 18 cases

Abstract

[Objective]To assess the value of neuronavigation system in surgery for pituitary adenomas in patients with sphenoid sinus dysplasia via single nostril.sphenoid approach.[Methods]Neuronavigation system guided tran-single nostril-sphenoid surgery was performed on 18 patients with sphenoid sinus dysplasia,admitted to our hospital from December 2010 to December 2011;2 patients were without sphenoid sinus,4 with sphenoid sinus fiont ofsella,9 ofsphenoid sinus being separated several rooms,and 3 of excessive gasification to 2 sides of middle cranial fossa.[Results] The positioned accuracy rate was 100％,and total resection rate was 77.8％.Thirteen patients (72.2％) were cured enjoying good endocrine result.No such severe postoperative complications as internal carotid artery and cavernous sinus injuries were noted in all the patients,except that transient polyuria occurred in 4 (22.2％) and CSF leakage in 1 (5.6％).[Conclusion] The neuronavigator-assisted trans-sphenoidal surgery in patients with sphenoid sinus dysplasia is helpful in improving the security of trans-sphenoidal surgery and reducing the local injury and serious complications,which extends the surgical indications to some extent. Key words: Neuronavigation; Sphenoid sinus dysplasia; Endonasal trans-sphenoidal approach; Pituitary adenoma