【摘要】 目的探讨经鼻内镜切除嗅神经母细胞瘤的疗效及辅助放射治疗的意义。方法对2001年8月至2005年9月经鼻内镜手术治疗的6例鼻腔鼻窦嗅神经母细胞瘤患者的临床特征、治疗效果及失败的原因进行回顾性分析。其中男4例,女2例;1例儿童,5例成人,年龄9～68岁;KadishB 期2例,C 期4例。所有病例随访14～63个月。结果 6例鼻腔鼻窦嗅神经母细胞瘤患者,5例肿瘤完全切除,包括1例先开颅手术,1例颅内侵犯经鼻内镜切除肿瘤并进行颅底修复,1例颈淋巴清扫术,1例次全切除。5例首次术后辅助放疗,均无瘤生存,1例未加放疗手术后复发带瘤生存至31个月死亡,中位生存期44.5个月。结论内镜手术具有手术进路简便,视野清晰,损伤小,术后恢复快,面部不留瘢痕,易为患者接受的优点。初步结果显示该术式是治疗鼻腔鼻窦嗅神经母细胞瘤的有效方法,但术后必须结合放射治疗方可获得满意效果。更多还原

【Abstract】 Objective To investigate the effectiveness of intranasal endoscopic resection of olfactory neuroblastoma and the significance of assistant radiotherapy.Methods Six patients(4 men and 2 women) ranging in age from 9-68 years(median age,48 years)with olfactory neuroblastoma treated endoscopically at the Third Affiliated Hospital of SUN Yat-sen University between August 2001 and September 2005 were retrospectively analyzed.The Kadish clinical stage was determined for all six cases,two cases with stage B, and 4 with stage C.The duration of endoscopic follow-up ranged from fourteen months to sixty three months. Results The tumor in five patients was completely excised including one case underwent craniotomy firstly and one case underwent neck dissection and the another case had her tumor subtotally resected.Five cases underwent assistant radiotherapy after operation without any evidence of recurrence so far,while the other one(Kadish stage B,tumor totally resection),who had no radiotherapy after first procedure,died from local recurrence and cerebellar metastasis 31 months after operation.The mediun survival duration was 44.5 months.Conclusions With simple approach,excellent visualization,a less operative invasiveness and no scar on face,the endoscopic approach appears to be the method of choice for the treatment of olfactory neuroblastoma.But it was necessary for good prognosis to combine with radiotherapy after operation.更多还原