Tài liệu Hội thảo Quốc tế về Nội soi và Phẫu thuật nội soi

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ENDOSCOPIC TRANSSPHENOIDAL

SURGERY FOR SELLAR TUMORS

<b> </b>

LE CONG DINH, A/Pr. PhD

ENT DEPARTMENT – BACH MAI HOSPITAL

SELLAR TUMORS

 10 - 15% of all intracranial tumors<b> </b>
 Most sellar tumors are benign

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SELLAR TUMORS

Clinical presentation:



Endocrin abnormalities



Visual troubles



Intracranial hypertension



....

SELLAR TUMORS

Treatment:



Medical



Radiosurgery

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<b> Việt nam </b>

<b>Before 2000: Transcranial approch</b>

<b>Since 2000 s: Sublabial Transseptal Transsphenoidal </b>
<b>+ Microscopic </b>

<b>+ C - arm</b>

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Since 2011: Endoscopic transsphenoidal
+ Navigation

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RESULTS (n = 80)

 _{Male : 39 (48,75%)}
 Female: 41 (51,25%)

 _{Average age (yr): 42}

SELLAR TUMORS (n = 80)

 Pituitary adenomas: 69

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Pituitary adenomas

Microadenoma Macroadenoma

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Chordoma

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RESULTS (n = 80)

Intraoperative complications:

 Hemorrhage : 11

 _{ICA injury : 0}
 CFS leaks : 12

 _{Strocke : 0}

RESULTS (n = 80)

Postoperative complications

 _{Diabetes insipidus : 9}
 _{Meningitis : 1}
 _{Middle turbinate-septum adhesion: : 5}
 Morbitity : 0

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RESULTS (n = 75)

Tumor resection rate: Brain MRI after 3 months

 Total: 43 (57,3%)

 _{Subtotal: 29 (38,7%)}
 Partial: 3 (4%)

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After surgery 3 months

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After surgery 3 months

CONCLUSION

<b> </b>

Endoscopic transphenoidal surgery for sellar tumors

 _{Minimal invasive}
 _Effective

 Less rhinological sequelae

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