摘要
目的 完整切除侵及前颅底区肿瘤 ,提高治愈率。方法 采用颅 -面联合径路 ,其中单用带血管蒂帽状腱膜 -颅骨膜瓣 4例 ,帽状腱膜 -颅骨膜瓣加肋骨片或钛网板各2例修补颅底。 8例未做颅底重建。结果 肿瘤全切 16例 ,无 1例手术死亡、长期脑脊液漏或 /和颅内感染 ,5例恶性肿瘤患者术后存活 3～ 5年 ;3例存活 1～ 2年 ;均未见肿瘤复发。另4例在 2年内分别死于局部复发和远处转移 ,4例良性肿瘤患者术后随诊 1～ 7年未见复发。结论 颅 -面联合径路前颅底区肿瘤切除术 ,具有术野大、显露清楚、安全可靠 ,有利于肿瘤整块切除。硬脑膜修补和颅底重建 。
Objective To fully resect tumors involving the anterior cranial base and to promote the survival rate and period. Methods Sixteen cases of tumors involving the anterior skull base received total resection by the combined craniofacial approach. Bone defects of the anterior skull base were reconstructed with pedical galea pericranium in 4 cases, and galea pericranium with rib sheets in 2 cases, and with titanium netplank in 2 cases. In the other 8 cases, reconstruction of defects in the anterior skull base was unnecessary. Results Of the 16 cases, full tumors were successfully removed, and no one died from the operation and presented any persistant CSF leak or/and intracranial infection. Five of the 16 patients with malignant tumors survived for 3～5 years, 3 for 1～2 years and 4 died from reccurrence and metastasis of tumor within 2 years post operation; the 4 cases with benign tumors were in good health with no reccurrence for 1～7 years. Conclusion The approach provides a large operative field, clear exposition and safe and reliable operation. To repair the dura and reconstruct the anterior skull base is very effective for the prevention of complications of CSF leak and intracranial infection. The surgical method should become regular for the treatment of tumors originated at or involving the ethmoid sinus.
出处
《中国耳鼻咽喉颅底外科杂志》
CAS
2000年第2期79-82,共4页
Chinese Journal of Otorhinolaryngology-skull Base Surgery
