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10例前颅底肿瘤的术式分析

Different surgical management of tumors in the anteriorskull base:a report of 10 cases

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【作者】 詹晓东王文忠韩跃峰蒋成义祖志将

【Author】 ZHAN Xiaodong WANG Wenzhong HAN Yuefeng JIANG Chengyi ZU Zhijiang(Department of Otorhinolaryngology-Head and Neck Surgery, Affiliated Hospital of Bengbu Medical College,Bengbu,233004, China)

【机构】 蚌埠医学院附属医院耳鼻咽喉-头颈外科蚌埠医学院附属医院耳鼻咽喉-头颈外科 安徽蚌埠233004安徽蚌埠233004安徽蚌埠233004

【摘要】 目的 :探讨鼻锥体下翻额正中进路前颅底肿瘤切除术在前颅底肿瘤中的应用。方法 :颅面联合进路前颅底肿瘤切除术 2例 ;经额下进路颅 眶 鼻沟通性肿瘤切除术 3例 ;鼻侧切开术 3例 ;鼻锥体下翻额正中进路前颅底肿瘤切除加额骨膜、髂骨瓣颅底修复和重建 2例。结果 :10例患者均完全切除瘤体 ,经 1~ 5年随访 ,良性肿瘤 6例无复发。恶性肿瘤 4例中 ,1例随访 1年生存良好 ;余 3例中生存 3年 2例 ,5年 1例。结论 :前颅底肿瘤需要根据肿瘤的大小、位置及性质选择最佳的手术进路。鼻锥体下翻额正中进路前颅底肿瘤切除术可在明视下进行手术操作 ,对额叶损伤轻 ,颅底修复方便 ,是一有价值的手术进路。

【Abstract】 Objective:To study the different surgical approach for the resection of tumors in the anterior skull base and to introduce an approach of the frontal mid-line incision with the nasal pyramid over-turned downward.Method:A review of 10 tumors in the anterior skull base employed unlike operative approach was presented. Of the 10 cases, 6 cases were benign tumors and 4 cases were malignant tumors. Two cases underwent the combined craniofacial approach, 3 cases the subfrontal approach, 3 cases the lateral rhinotomy approach, 2 cases the approach of the frontal mid-line incision with the nasal pyramid over-turned downward.Result:All tumors were totally resected. All patients were followed up from 1 to 5 years. In the benign tumors group, 6 cases achieved good results and no recurrence. Of the 4 cases with malignant tumors, 1 cases were followed up 1 year and is alive,2 cases survived after 3 years and 1 case died after 5 years. Three cases died from local recurrence or invaded intra-cranial.Conclusion:According to the site, range and pathology of the skull base tumors, the best operative approach should been selected. The approach of the frontal mid-line incision with the nasal pyramid over-turned downward is closer to tumor and easy to repair duramater,has fine exposure of the anterior skull base, minimal retraction of the frontal lobe, and has better clinically worthy.

  • 【文献出处】 临床耳鼻咽喉科杂志 ,Journal of Clinical Otorhinolaryngology , 编辑部邮箱 ,2004年09期
  • 【分类号】R739.4
  • 【被引频次】5
  • 【下载频次】73
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