摘要
目的 :探讨累及前颅底或颅内脑组织的鼻腔副鼻窦癌的手术切除途径及方法。方法 :经颅面联合进路行显微外科连续整块切除累及前颅底或颅内脑组织的鼻腔副鼻窦癌 15例 ,其中 5例仅累及前颅底 ,10例累及前颅底至颅内额叶脑组织。硬脑膜缺损应用大腿阔筋膜修补。结果 :15例均作了术后随访 ,随访时间最长为 10年 ,最短为 2年。其中 4例为初治患者 ,11例为综合治疗后局部复发患者。 9例无瘤生存 2年以上 ,2年无瘤生存率为60 .0 0 %。 11例接受此手术行拯救外科治疗 ,其中 6例无瘤生存 2年以上 ,2年拯救成功率为 5 4 .5 5 %。结论
Objective: To investigate the approach and resection technique for the tumors of nasal cavity and paranasal sinuses invading the anterior skull base or the intracranial brain tissue. Method: Fifteen patients were operated for the tumor of nasal cavity and paranasal sinuses involving the anterior cranial base or the intracranial tissue through conbined craniofacial approach with en bloc microsurgical resection. Among them, five cases had the cancer involving the anterior cranial base and ten cases involving the intracranial tissue through the anterior cranial base. The dural defects resulted from resection were repaired with femoral fascia. Results:Fifteen cases have been followed up 2 10 years since the operation. There were 9 patients (60%) have been tumor free survival for 2 years. Eleven patients underwent the operation for salvaged surgery. Among them 6 cases have been tumor free for more than 2 years.The 2 year successuful rate for salvaged surgery was 54.55%. Conclusion:It is feasible to remove the tumors of the nasal cavity and paranasal sinuses invading anterior cranial base or the intracranial tissue through combined craniofacial approach with en bloc resection microsurgically. Key words: Nasal cavity and paranasal sinuses; Tumour; Skull base; Microsurgery。矗恚? ａｎｄ １％ ｌｉｄｏｃａｉｎｅ ８ｍｌ．Ｉｎ ｇｒｏｕｐ Ｂ（ｃｏｎｔｒｏｌ），ｅｐｉｄｕｒａｌ ｉｎｊｅｃｔｉｏｎ ｗａｓ ｍａｄｅ ｏｎｃｅ ｐｅｒ ｗｅｅｋ ｗｉｔｈ １％ ｌｉｄｏｃａｉｎｅ．Ｔｈｅ ａｎｅｓｔｈｅｔｉｃ ｏｎｓｅｔ，ｒａｎｇｅ ａｎｄ ｄｅｇｒｅｅ ｗｅｒｅ ｏｂｓｅｒｖｅｄ ｉｎ ｔｈｅ ｔｗｏ ｇｒｏｕｐｓ．Ｆｕｒｔｈｅｒｍｏｒｅ，ｔｈｅ ｒｏｅｎｔｇｅｎｏｇｒａｐｈｙ ｏｆ ｅｐｉｄｕｒａｌ ｓｐａｃｅ ａｎｄ ｂｉｏｐｓｙ ｏｆ ｅｐｉｄｕｒａｌ ｔｉｓｓｕｅｓ ｗｅｒｅ ｍａｄｅ ｏｎ ｔｗｏ ａｎｉｍａｌｓ ｅａｃｈ ｔｉｍｅ ｉｎ ｅｉｔｈｅｒ ｇｒｏｕｐ ３，５，７，９ ａｎｄ １１ ｗｅｅｋｓ ａｆｔｅｒ ｔｈｅ ｂｅｇｉｎｎｉｎｇ ｏｆ ｏｂｓｅｒｖａ ｔｉｏｎ． ＷＴＨＺ Ｒｅｓｕｌｔｓ The anesthesia range was narrowed and anesthesia duration was shortened with the prolongation of epidural catheter placement,Epidural roentgenography showed that the medium dif fused normally within epidural space,biopsy of epidural tissues showed that there were inflammative cells infiltration and fiber proliferation with longer epidural catheter placement(more than 4 weeks),without significant differences between both groups.Conclusion Epidural corticosteroids can not prevent epidural adhesion from occurrance induced with long term epidural catheter placement
出处
《癌症》
SCIE
CAS
CSCD
北大核心
2000年第2期175-176,180,共3页
Chinese Journal of Cancer
关键词
鼻腔副鼻窦癌
显微外科手术
手术进路
Injections,epidural Adrenal cortex hormones Adhesions Epidural space
