应用内镜经鼻蝶后床突切除垂体移位经灰结节入路切除三脑室型颅咽管瘤的手术经验

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目的探讨内镜经鼻蝶后床突切除垂体移位经灰结节入路切除三脑室型颅咽管瘤的手术治疗效果。方法回顾性分析2022年7月于复旦大学附属中山医院神经外科就诊并行内镜经鼻蝶后床突切除垂体移位经灰结节入路切除的1例三脑室型颅咽管瘤患者的临床资料，并结合相关文献进行复习。结果内镜经鼻蝶后床突切除垂体移位可充分暴露三脑室底灰结节区域，打开灰结节能进入三脑室内全切除肿瘤。术后无并发症发生。随访半年未见肿瘤复发。结论内镜经鼻蝶后床突切除垂体移位经灰结节入路为三脑室型颅咽管瘤提供了一种新的入路。此入路能较好地由下而上暴露三脑室内前部病变，避免了视交叉的牵拉损伤。

Objective To explore the treatment of endoscopic endonasal pituitary transposition trans-tuber-cinereum approach(EEPTTCA) for resection of the third ventricle craniopharyngioma. Methods The clinical data of a patient underwent third ventricle craniopharyngioma resection by EEPTTCA at the Department of Neurosurgery, Zhongshan Hospital, Fudan University in July 2022 were analyzed retrospectively. The relevant literature were also reviewed. Results EEPTTCA could expose tuber cinereum clearly and trans-tuber-cinereum approach could totally resect the tumor originated from the third ventricle. There were no postoperative complication. No tumor recurrence was observed during six-month follow-up. Conclusions EEPTTCA is an alternative route for this special type of craniopharyngioma.This approach can effectively expose the anterior lesions of the third ventricles from bottom to top, avoiding traction damage to the optic chiasm.