Endo-nasal trans-sphenoidal approach in removal of pituitary adenomas under CT-based neuro-navigation.

Objective To explore the application of neuron-avigation in the removal of pituitary adenomas by the endo-nasal trans-sphenoidal approach.Methods 62 patients with pituitary adenomas had 2 mm CT scans before surgery.All the operative procedures were done under the guidance of navigation.Results Among the 62 patients,total resection was achieved in 42 patients,subtotal in 19,and partial in 1 There were no deaths,rehaemorrhagia,meningitis,and perforated nasal septum.After a follow-up of 2 months to 2 years in 52 patients,no recurrence was found.Of 36 patients with visual loss,33 patients had postoperative improvement.There was no improvement in 3 patients with acroisa before the operation.Of 7 patients with menstrual disorder or amenorrhea,4 patients had improvement.Of 6 patients with high PRL,4 patients returned to a normal hormone level.ll 6 patients with high GH returned to a normal hormone level.CSF leakage was found in 2 patients,temporary diabetes insipidus was found in 2 patients,electrolyte disturbance was found in 4 patients,and all patients recovered after treatments.Hypopituitarism was found in 4 patients and needed to be treated with hormones for a long time.Conclusion CT-based neuro-navigation in the removal of pituitary adenomas by endonasal trans-sphenoidal approach is helpful in improving accuracy and reliability,raising the tumor removal rate and reducing surgical complications.