Transsphenoidal microneurosurgery—第4報 下垂体腺腫における眼症状とその改善率

Transsphenoidal Microneurosurgery-Part 4: Neuroophthalmological cure in pituitary adenoma

I．はじめに

　われわれは，200例におよぶtranssphenoidal routeによる下垂体手術におけるその術式，morbidity, mortality，下垂体腺腫における内分泌機能の改善，術後の水・電解質代謝異常の動向などについて報告してきた^11-13）．今回は下垂体腺腫と最も密接な神経学的所見としての眼症状につき分析し，術後のその改善率と，それに影響する諸因子につき検討した．

Fifty-nine pituitary adenomas treated with transsphenoidalapproach were analyzed in the light of visual field defectsand the postoperative cure rates. Twenty-six cases had visualfield defects. The majority of the defects were temporal 1/2or superior 1/4, although atypical deficits such as incongruous homonymous hemianopsia, nasal 1/2 defect, superior1/2 defect, peripheral constrict were seen. The visual fielddefects were correlated with the size of the tumor in Hardyand Vezina classification of the suprasellar extension. Thevisual field defects appeared in 100% of Type C, 89% ofType B, 50% of Type A, 0% of Type O.