【摘要】 目的探讨经鼻内镜下切除经颅手术后复发性前颅底肿瘤的方法和价值。方法经颅手术后复发性前颅底肿瘤8例,分别为嗅母细胞瘤3例、嗅沟脑膜瘤3例、高分化腺癌1例、血管内皮瘤1例。均在内镜下经鼻切除筛顶、筛板、前颅底硬脑膜和硬脑膜下的肿瘤,手术后严密重建颅底缺损。结果 8例肿瘤均获得全切(全切率100%);无致残和致死性手术并发症;随访3个月至36个月,1例嗅母细胞瘤患者术后1年死于远处转移,余7例无瘤生存。结论经鼻内镜入路是切除开颅手术后复发性前颅底肿瘤的有效外科手段,但应严格把握手术适应证。更多还原

【Abstract】 Objective To explore the method and feasibility of intranasal endoscopic resection of recurrent anterior skull base tumors after transcranial surgery. Methods Eight patients with recurrent anterior skull base tumors were included in this study. The tumors included olfactory neuroblastoma( 3 cases),olfactory groove meningioma( 3 cases),well-differentiated adenocarcinoma( one case),and hemangioendothelioma( one case). Intranasal endoscopic surgical procedures were adopted in all 8 cases for resection of cribriform roof,lamina cribrosa,dura mater of anterior skull base,and subdural tumors. The skull base defects were carefully reconstructed. Results Total tumor resection was obtained in all 8 cases( 100 %). No serious complications such as disability and death occurred.Follow-up of 3 months to 3 years showed that 7 patients were alive without recurrence and the patient with olfactory neuroblastoma died of distant metastasis 1 year after surgery. Conclusion Intranasal endoscopic approach,as long as proper choice of surgical indications,is a valuable surgical procedure for resection of recurrent anterior skull base tumors after transcranial surgery.更多还原