Objective To assess the value of neuronavigation in the resection of pituitary adenomas by endonasal transsphenoidal approach. Methods 32 patients with pituitary adenomas accepted the continuous and thin slice CT or MRI scans before surgery, the data was transported to the Brain LAB Vector Vision neuronavigation system and reconstructed in three dimensions. The anterior sphenoidal wall ,sellar floor, internal carotid artery, cavernous sinus ,clivus and pituitary adenoma were marked and the best approach was designed according to the above data. In operation, the above structures could be precisely localized by the navigation system. Under the monitor of neuronavigator, the tumor was removed completely and carefully. Results We could reach the tumor site smoothly and accurately under the neuronavigation by transsphenoidal approach. The registration deviation of the 32 cases were ranged from 0. 3 ~2. 5 mm, Total resection was a-chieved in 24 patients, subtotal resection was achieved in 6 patients and major resection in 2 patients. The postoperative symptoms were improved in 26 patients, no change in 6 patients. There were no severe complications after surgery. Conclusions The application of neuronavigation in the endonasal transsphenoidal approach is helpful to improve the accuracy and the rate of total resection during surgery and decrease complications after surgery.%目的 观察神经导航系统引导单鼻孔蝶窦入路垂体瘤切除术的应用效果.方法 32例垂体瘤患者,术前行MRI或CT薄层扫描,将图像资料输入Brain LAB Vector Vision神经导航系统中进行三维重建,据此设计最佳手术入路,并对肿瘤及重要结构作标记；术中在神经导航系统的引导下寻找蝶窦前壁、鞍底、颈内动脉、海绵窦和斜坡等结构,切除肿瘤.结果 32例均在神经导航引导下经鼻蝶入路顺利到达肿瘤部位,注册误差0.3～2.5 mm；肿瘤全切除24例,次全切除6例,大部切除2例；术后26例症状有不同程度的改善,6例无变化,无严重并发症出现.结论 神经导航引导单鼻孔蝶窦入路垂体瘤切除术定位准确、肿瘤全切除率高、并发症少.
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