CT誘導下経蝶形骨洞腫瘍摘出術9症例の検討

CT Guided Transsphenoidal Surgery: Report of nine cases

I．はじめに

　われわれは，脳神経外科手術室に手術室用CTスキャナーシステム^8）を導人し，様々な応用について検討報告してきた．今回は手術室用CTを新たに経蝶形骨洞腫瘍摘出術に応用し，9症例のトルコ鞍近傍病変に対しCT誘導下経蝶形骨洞腫瘍摘出術を行った．そこで本法の有用性ならびに従来のX線透視装置を用いたHardy法との比較につき検討を加え報告する．

We have developed a Computed Tomography system for use in the operating room and applied this CT sys-tem to intraoperative monitoring during transsphenoid-al surgery. This system includes Toshiba TCT-300 CT system, mobile CT scanner gantry, digitally controlled operating table and head fixation system. Between Jun. 1989 and Dec. 1989, CT guided transsphenoidal surgery was carried out in 9 cases in our department. The su-prasellar masses were visualized directly during trans-sphenoidal surgery and were removed safely and effi-ciently. Under this CT monitoring system the surgeon can obtain accurate information about the location and volume of residual tumor as well as about the impor-tant surrounding deeper structure. Another advantage of this system is that the digitally controlled operating table makes it possible to keep the patient in a head-up position, which lessens oozing from the parasellar re-gion during transsphenoidal surgery. We believe the best application of this method is that for pituitary tumor with moderate suprasellar extension.

Nine cases were reported in this paper which were operated on using this system. To our knowledge, this is the first report of use of intraoperative CT monitor-ing during transsphenoidal surgery.