摘要
目的 探讨经上颌入路显微切除斜坡区肿瘤的指征、要点及优缺点。方法 采用以正颌外科LeFortⅠ型截骨术为基础的经上颌入路显微切除斜坡区巨大肿瘤 16例 ,对临床资料进行回顾性总结。结果 16例中脊索瘤 8例 ,血管纤维瘤 2例 ,垂体腺瘤 1例 ,软骨瘤 1例 ,骨髓瘤 1例 ,腺癌Ⅱ级 1例 ,粘液囊肿 1例 ,骨纤维结构不良 1例。 16例中 4例曾在其他医院行手术切除后复发。全部患者术中暴露满意 ,10例肿瘤镜下全切除 ,6例次全切除 ,并发症包括 1例脑脊液鼻漏 ,3例咬合障碍 ,无死亡、偏瘫等严重并发症。对本组患者随访 6～ 4 0个月 ,平均随访 2 0个月 ,其中 4例分别于术后 1年、1年半、2年、9个月局部复发 ,余皆恢复正常生活。结论 经上颌入路切除斜坡肿瘤具有暴露充分、肿瘤切除彻底、并发症少的优点。该入路是切除斜坡中线部位巨大肿瘤的较佳入路。
Objective To investigate the indications, key point, advantages, and disadvantages of transmaxillary approach for microsurgical removal of clivus tumors. Methods The clinical data of 16 consecutive patients with clivus tumors operated upon through transmaxillary approach, based on Le Fort I ostoectomy, July 1999 to May 2002 were retrospectively reviewed. Results Of the 16 patients, 8 patients suffered from chordoma, 2 from angiofibroma, 1 from pituitary adenoma, 1 from chondroma, 1 from adenocarcinoma of grade II, 1 from mucid cyst, 1 from myeloma, and 1 from fibrous dysplasia of bone. Four out of the 16 cases were with recurrent tumors after operation performed in other hospitals. The operation field of all 16 patients was satisfactorily exposed. The tumors of 10 cases were totally removed under microscope, and 6 tumors were subtotally removed. The complications included rhinorrhea in 1 case and malocclusion in 3 cases. There was no operative mortality. All patients were followed up for 6～40 months (ion average 20 months) with MRI. Four of them had local recurrence within 1 year, 1.5 years, 2 years, and 9 months respectively after operational and have lived with tumors till now. The remainders had resumed their normal life. Conclusion An ideal approach, transmaxillary approach facilitates the resection of clivus tumors, with satisfying exposure and fewer complications.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2003年第17期1490-1492,共3页
National Medical Journal of China
基金
江苏省科技厅社会发展资助项目 (BS2 0 0 0 0 5 0 )
