뇌하수체 종양 수술에서 변형된 Killian 절개를 사용한 비중격 연골 제거 및 재위치 방식의 경비중격 경접형동 접근법의 임상적 유용성: 42예에 대한 분석

Abstract

Background and Objectives: The conventional transseptal transsphenoidal approach can inhibit visualization of the surgicalfield and may change the shape of external nose. We used the transseptal transsphenoidal technique to remove septal cartilageexcept the L strut via a modified Killian’s incision and preserved the ‘key-stone area.’ The aim of this study was to verify theusefulness of this technique. Subjects and Method: Retrospective analysis was carried out on 42 pituitary tumor patients who received this technique bya single otolaryngologist from March 2005 to March 2012 at Kangbuk Samsung Hospital. Results: The mean patient age at time of surgery was 52 years, and 41 cases were pituitary adenoma and 1 was Rathke’s cleftcyst. Three patients had undergone prior surgery; of which 2 used a pterional approach and 1 a transsphenoidal approach. Withregard to complication, there were 2 cases of CSF leakage and 5 cases of septal laceration. There were no cases of meningitis,deformity of external nose, septal perforation, anosmia, or sinusitis. In post operation follow up, 25 cases (59.5%) had no residualtumor, while 17 cases (40.5%) had residual tumor. Conclusion: This study reveals that transseptal transsphenoidal surgery with septal cartilage removal and a replacement techniquefor a pituitary tumor are effective, allow easy exposure, and result in a low complication rate.