Extended Endoscopic Endonasal Transsphenoidal Approach For Resection Of Skull Base Tumor

Objective： To investigate the extended endoscopic endonasal transsphenoidalapproach for resection of skull base tumor surgery, surgical indications, surgical results,and complications prevention and treatment strategies. Methods: A retrospective analysisof the case records of30patients operated for skull base tumor by the endoscopicendonasal transsphenoidal approach between2011February and2012December, the mainanalysis of surgical techniques, effects and complications prevention and treatmentstrategies. Results：all patients underwent operations successfully without fatality. Amongthe30cases, total resection was completed in23, muity partial resection in5and partialresection in2. The main complication was cerebrospinal fluid rhinorrhea in8patients(26%),6cases of lumbar continuous drainage of conservative treatment cure, cure the twopatients with endoscopic transsphenoidal repair; The hypopituitarism5cases (17%), fivecases of hormone replacement therapy, gradually returning to normal pituitary function;Transient diabetes insipidus15cases,1case of diabetes insipidus requires long-term useMinirin treatment, remaining postoperative diabetes insipidus after treatment, thesymptoms disappeared within1week; Nasal bleeding patients given gauze packing twodays to cure; Cases of cerebrospinal fluid leakage in patients with intracranial infection,given antibiotics cure. Followed up for6months to3years, the majority of patients withclinical symptoms disappeared or reduced,1relapse had recommended radiotherapy aftersurgery, but the patients was not follow instructions to radiotherapy. Conclusion:Endoscopic expand transnasal approach can be satisfied to resection of the anterior skullbase, saddle, cavernous sinus, slopes and craniocervical junction of lesions, such as:anterior skull base meningiomas, suprasellar craniopharyngioma, giant pituitary adenomas,Rathke cyst, cavernous sinus invasion of pituitary adenoma, the junction of the slopes andcraniocervical chordoma, notochord sarcoma. Use this method to remove the tumor, resection rate of tumor highly, complications light, and the patients recovered faster.