摘要
目的 探讨颅底肿瘤切除的最佳手术入路。方法 回顾分析 1993～ 2 0 0 0年中国医学科学院中国协和医科大学肿瘤医院外科处理侵及颅底肿瘤 84例的经验 ,讨论侵及颅底不同部位病变手术入路特点 ,以求选择最好的手术入路彻底切除肿瘤 ,同时尽量保护颅底、颅内重要结构 ,减少并发症。结果 患者年龄 6～ 78岁 ,平均 4 3 8岁。良性肿瘤 14例 ,恶性肿瘤 70例。采用各种手术入路切除累及咽旁颅底肿瘤 38例 ;同时有前、中颅底破坏 7例 ;肿瘤同时累及中、后颅底 13例 ;侧颅底颞下窝肿瘤 2 6例。用各种组织瓣修复颅底缺损或填充 6 0例。 6例并发脑脊液漏 ,2例迟发脑脓肿 ,修复组织瓣部分坏死 3例 ,无手术死亡及严重颅脑并发症。恶性肿瘤 3年生存率 6 7 5 % (2 7/ 4 0 )。结论 最佳手术入路的选择应相对于颅底不同部位的肿瘤 ,针对特殊的解剖结构而选择 ,可以根据以下几个因素综合考虑 :①肿瘤部位及累及的范围 ;②安全、充分地切除肿瘤 ;③正常功能结构及外观影响小 ;
Objective To seek for a better approach for the resection of skull base tumors Methods A review of 84 skull base tumors resection employed unlike operative approach in the Cancer Hospital of Chinese Academy of Medical Sciences was presented Surgical approach feature of invaded the different position of skull base, selects the best operative access for safely removes the tumor, protects the critical structure of skull base as fully as possible, and decreases the complication were discussed in this article Results Fourteen cases of benign and seventy cases of malignant underwent surgery The tumor in 38 cases implicated parapharyngeal space and skull base The lesion synchronously involved the anterior and middle cranial fossa in 7 cases,middle and posterior cranial fossa in 13 cases,lateral cranial base in 26 cases The survival rate at 3 years was 68 5%(27/40) for malignant tumor There was no operative death and severe complication in this series Conclusion To select the best operation access should think over following factors:1 Tumor position and the scope implicated 2 Safely and fully removal of the tumor 3 The limited destroy to normal function structure and receivable cosmetic effect 4 It is convenient to reliable reconstruction
出处
《中华耳鼻咽喉科杂志》
CSCD
北大核心
2002年第2期95-98,共4页
Chinese Journal of Otorhinolaryngology
关键词
颅底肿瘤
手术切除
手术入路
Skull base neoplasms
Surgical procedures, operative
Otorhinolaryngologic surgical procedures
