【摘要】 目的探讨分析鼻内镜手术在治疗儿童颅底肿瘤中的应用。方法回顾性分析中南大学湘雅医院鼻颅底外科2010年6月—2019年11月收治确诊为颅底肿瘤并行鼻内镜治疗的患儿共44例,其中鼻咽纤维血管瘤17例,朗格汉斯组织细胞增生症7例,骨化纤维瘤5例,原始神经外胚层肿瘤2例,横纹肌肉瘤2例,脑膜瘤2例,间叶性软骨错构瘤1例,颅咽管瘤1例,表皮样囊肿1例,血管纤维脂肪瘤1例,生殖细胞瘤1例,骨母细胞瘤1例,脊索瘤1例,侵袭性垂体腺瘤1例,纤维瘤病1例。结果 44例患儿中43例在鼻内镜下完全切除,仅1例鼻咽纤维血管瘤分期切除。术后44例均进行定期随访,随访时间3个月至9年。5例失访,其中骨母细胞瘤1例,脑膜瘤1例,横纹肌肉瘤1例,鼻咽纤维血管瘤2例;12例术后接受放化疗,其中朗格汉斯组织细胞增生症7例,原始神经外胚层肿瘤2例,横纹肌肉瘤1例,脊索瘤1例,生殖细胞瘤1例,随访至今患儿状况良好,均无复发及转移;1例鼻咽纤维血管瘤复发;再次手术后治愈;其余26例患儿术后未见复发。结论鼻内镜颅底手术治疗儿童颅底肿瘤是可行、有效及安全的。更多还原

【Abstract】 Objective To explore the application of endonasal endoscopic surgery for pediatric skull base tumors.Methods Clinical data of 44 pediatric patients who received endoscopic endonasal skull base surgery for skull base tumors between June 2010 and Nov 2019 were analyzed retrospectively. The tumors included juvenile nasopharyngeal angiofibroma(JNA)(n=17), Langerhans histiocytosis(LCH)(n=7), ossifying fibroma(n=5), primitive neuroectodermal tumor(PNET)(n=2), rhabdomyosarcoma(n=2), meningioma(n=2), cartilage mesenchymal hamartoma(n=1), craniopharyngioma(n=1), epidermoid cyst(n=1), angiolipoma(n=1), germ cell tumor(GCT)(n=1), osteoblastoma(n=1), chordoma(n=1), invasive pituitary adenoma(IPA)(n=1), and fibromatosis(n=1).Results Endoscopic complete tumor resection was achieved in 43 children, and resection of JNA was performed in three stages in one case. All the 44 cases were followed up for 3 months to 9 years postoperatively. Among them, 5 cases were lost to follow up, including 1 with osteoblastoma, 1 with meningioma, 1 with rhabdomyosarcoma, 2 with JNA. Except for the 5 patients lost to follow-up, 12 cases(7 with LCH, 2 with PNET, 1 with rhabdomyosarcoma, 1 with chordoma and 1 case with GCT) received postoperative radiotherapy and chemotherapy, and they were all in good condition with neither recurrence nor metastasis during follow-up period.One patient had recurrence of JNA, which was cured after reoperation. No recurrence was found in the rest 26 cases.Conclusion Endonasal endoscopic skull base surgery is feasible, effective, and safe for pediatric skull base tumor.更多还原