摘要
本文了介绍２１例前颅底恶性肿瘤整块切除及颅底、颌面部缺损修复治疗方法。根据肿瘤的大小及周围组织侵犯范围，制定了肿瘤部位切除方法的分类，根据其分类来设定肿瘤切除范围及缺损修复方法的选择。本手术方法，不仅能够完整地切除肿瘤，而且可以一期进行肿瘤切除后的颅底、颌面以及硬膜缺损的修复，有效地防止术后脑脊液漏等并发症的发生。本方法特别适用于鼻窦、颌面部恶性肿瘤向颅底侵犯的病例，以及颅底内、外肿瘤需手术切除的病例。本文还特别提出颅底、颌面缺损修复时的并发症及注意事项。
Over the past 5 years from September 1991 to August of 1996, we have experienced 21 cases of anterior skull base malignent tumors which underwent enbloc excisions by transbasal and transfacial approach done by the skull base surgery team in Kansai Medical University Hospital. Patients,16 males and 5 females,ranged in age at the operation from 13 to 72 (mean 52.6). By histology, there were 8 squamous cell carcinomas,4 olfactory neuroblastomas and 9 other malignancies.The locations where the tumors originated were ethmoid sinus in 14 cases,maxillary sinus in 5 and parapharyngeal space in 2. The lesions were treated surgically by the three types of enbloc excision with surrounding tissues which we have paeviously developed;type A resection was done to 11 cases in which anterior skull base and medial orbital wall were removed and pericranial flap was used for skull base sealing,type B resection was done to 6 cases in which anterior skull base,orbital contents and a part of maxilla were removed and repaired with free tissue transfer,and type C resection was done to 4 extensive cases in which anterior skull base, orbital contents, maxilla and palate were removed and reconstructed with free tissue transfer and bones. The enrolled 21 cases have been followed postoperatively for 2.5 years on an average and the outcomes have been evaluated into excellent in 5 (23.8%), good in 10 (47.6%), and poor in 4 (19.0%) out of 19 cases which have been followed for more than one year. The reccurence of the tumor was seen in 4 cases (19.0%) and postoperative complications occured in 8 cases (38.1%).
出处
《中国耳鼻咽喉颅底外科杂志》
CAS
1996年第4期222-227,共6页
Chinese Journal of Otorhinolaryngology-skull Base Surgery
关键词
颅底肿瘤
前颅凹底
外科手术
Tumor, skull base\ Approach\ Enbloc excision
