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1910年Cushing首述唇下经中隔-蝶窦的垂体瘤手术,迄1925年已行231例,后因经鼻径路狭窄、暴露困难而改行开颅术。1968年Hardy再次采用经鼻途径并引入手术显微镜及术中照片。随定位、照明、放大、抗生素及激素替代疗法的应用,遂使经中隔-蝶窦法成为垂体手术的当代标准术式,可沿解剖中线安全地暴露蝶鞍。然典型的唇下法具严重缺点,如上唇妨碍术野暴露、因凿除鼻棘可致鼻尖消失、术后常见牙麻木、佩戴假牙困难,而外鼻成形术径路可克服上述缺点。方法如下:患者平卧、头后伸,经口行气管插管麻醉,鼻小
In 1910 Cushing first under the lip through the septum - sphenoid sinus pituitary surgery, as of 231 has been carried out in 231 cases, due to nasal stenosis, exposure and switch to craniotomy. In 1968 Hardy once again adopted the nasal route and the introduction of surgical microscopes and intraoperative photographs. With the positioning, illumination, magnification, antibiotics and hormone replacement therapy applications, so by transseptal - sphenoidal sinus surgery as the standard contemporary pituitary surgery, safe dissection of the sella along the midline sella. However, the typical lip method has serious shortcomings, such as the upper lip obstructing the operative field exposure, due to chiseling except nasal can cause disappearance of the nose, common teeth and numbness, wearing dentures difficult, and nasaloplasty path can overcome the above shortcomings. Methods are as follows: patients supine, head extension, oral intubation anesthesia, nasal small