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Oral Complication of Sublabial Transsphenoidal Surgery and Advantages of Endonasal Transsphenoidal Approach Kazunori ARITA 1 , Tohru UOZUMI 1 , Takashi YANO 1 , Kaoru KURISU 1 , Taizo HIROHATA 1 , Takashi SADATOMO 1 , Akihiko TAKECHI 1 , Kuniki EGUCHI 1 , Koji IIDA 1 1Department of Neurosurgery, Hiroshima University School Keyword: Transsphenoidal surgery , Sublabial approach , Endonasal approach , Complication pp.119-124
Published Date 1994/2/10
DOI https://doi.org/10.11477/mf.1436900781
  • Abstract
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In order to know the exact incidence of oral com-plications due to the sublabial transsphenoidal approach, the authors meticulously heard the corn-plaints of 46 patients, who had undergone the approach more than 3 months before.

The incidence of the patients who had one or more complaints concerning the oral region was 52.2%. Dysesthesia of the upper lip was most frequent (37%), followed by upper lip pain (17.4%). These complaints were more marked in two patients who had undergone operations using the sublahial approach twice. Among the nine patients with dentures, the dentures had to be remade in three patients because of gigival atrophy several months after the use of the sublabial approach. With a view to overcoming these complications, the authors adapted the endonasal transsphenoidal appro-ach in 13 patients. There was no inconvenience during surgery while this approach was being used, and there were no postoperative oral complications. Among three patients using dentures, there were none who needed remodeling of their dentures. In nine patients, the ten-sion reducing incision was made in the bottom of the columella, which caused no cosmetic problem. Further-more, the time consumed for approaching the sphenoid sinus was less than that required when using the subla-bial approach.

In conclusion, the following type of patient is be-lieved to be an appropriate candidate for endonasal approach. A patient who has a relatively smaller sellarlesion and 1) An acromegalic patient whose nostril is relatively large, 2) An elderly patient using dentures, 3) A patient who has undergone previous transsphenoidal surgery, or 4) A patient whose columellar crease is hidden.

This approach can be applied even with the Japanese population, in whom it has seldom been applied, be-cause of the supposition that their nostrils are too nar-row for the use of this approach.


Copyright © 1994, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1251 印刷版ISSN 0301-2603 医学書院

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