【摘要】 目的:探讨颅底肿瘤面骨移位入路手术切除的可行性、方式和临床效果。方法:总结我院口腔科联合神经外科自2003年2月—2007年7月收治且行面骨移位入路手术切除的14例颅底肿瘤患者的临床资料。手术采用上颌骨LeFortⅠ型截骨加上颌骨正中劈开显露6例,一侧上颌骨截骨外旋显露5例,颧骨、颧弓和下颌支截骨旋转显露3例。全部病例术后随访0.5～4a,评价手术疗效和术后并发症。结果:全部患者手术顺利,均达到良好的手术显露,术中及术后无严重手术并发症。9例良性肿瘤,无1例复发;5例恶性肿瘤中,1例术后1年复发,开颅二次手术后颅内感染死亡;生存1年以上1例,2年以上2例,3年以上1例。结论:面骨移位方式可以为颅底肿瘤的手术切除提供显露良好的手术入路。更多还原

【Abstract】 PURPOSE: To evaluate the clinical possibility, methods and results of cranial base tumor resection via facial bone osteotomy approaches. METHODS: Fourteen cases of cranial base tumors underwent surgical treatment via facial bone osteotomy from Feb. 2003 to Jul. 2007 in the Department of Neurosurgery and Oral and Maxillofacial Surgery, Xinqiao Hospital. Six patients underwent a 2-piece Le FortⅠosteotomy of maxilla for cranial base access. Five cases had unilateral maxillary osteotomy of swing approach for skull base exposure. The zygomatic-temporal-mandibular osteotomy access to cranial base was used in other three patients. All patients were follow-up for 0.5 to 4 years after surgery. The surgical results and complications were recorded and analyzed. RESULTS: All patients had good surgical exposure and reached the purpose of tumor excision without severe complications during and after surgical management. No recurrence was noted postoperatively in 9 cases with benign tumors. Of the 5 malignant tumors, one recurred 1 year postoperatively and died of intracranial infection after craniocerebral operations. During the follow up period, one patient survived over two year, two cases survived over 2 years, 1 case survived over 3 years. CONCLUSION: Facial bone osteotomy resection can provide good accesses for surgical exposure and management of cranial base tumor.更多还原