경비중격 경접형동 뇌하수체 수술 후의 비중격과 접형동의 구조에 대한 전산화단층촬영을 이용한 평가

Background and Objectives: Many surgical approaches have been used for removal of the pituitary lesions. Transseptal transsphenoidal approach (TSA) for pituitary tumor is well-established surgical technique in these approaches. After TSA, many rhinologic complications have been reported because this method is manipulated along the entire length of the nasal septum for opening sphenoid sinus. But, postoperative evaluation of frameworks of the septum and sphenoid sinus after TSA has not been reported. So, this study was to evaluate changes of frameworks of the septum and sphenoid sinus seen on CT scan after TSA compared to preoperative CT scan within several years. Material and Methods: 11 patients (male: 6, female: 5/mean age: 48.7 years) with pituitary tumor resection were accomplished through TSA were prospectively studied with CT scans. 2 patients with TSA after 1 year (Group 1), 2 patients with TSA after 2 years (Group 2), 3 patients with TSA after 3 years (Group 3) , 2 patients with TSA after 4 years (Group 4) , 2 patients with TSA after 5 years (Group 5) were studied. Preoperative CT scans were compared with postoperative CT scans after TSA during 5 years intervals including degree of septal deviation, frameworks of entire septum, shape of the anterior wall of sphenoid sinus, pneumatization pattern of sphenoid sinus in each groups. Results: All patients had remarkably similar to frameworks of the septum and sphenoid sinus seen on postoperative CT after TSA compared to preoperative CT scan. Conclusion: This study demonstrated that time dependent changes of frameworks of the septum and sphenoid sinus afer TSA for pituitary tumor resection showed no distinctive characteristics. TSA for puituitary surgery was found to be safe without changes of frameworks of the septum and sphenoid sinus. (J Clinical Otolaryngol 2007^;18:47–53)