鼻内镜下鼻窦颅底区域手术  

Application of endoscopic treatment in the surgery of disease involving sinus and skull base

作　　者：张勤修[1] 刘世喜[1] 安会明[1] 覃刚[2] 

机构地区：[1]四川大学华西医院耳鼻咽喉科,四川成都610041 [2]泸州医学院附属医院耳鼻咽喉科,四川泸州646000

出　　处：《中国内镜杂志》2006年第4期337-340,共4页China Journal of Endoscopy

基　　金：四川省卫生厅2004年科研项目(No:040126);2005年四川省自然科学基金(050324)资助

摘　　要：目的探讨鼻内镜下鼻窦颅底区域疾病手术的价值。方法回顾性总结鼻腔内镜下鼻窦颅底区域手术病例98例,其中脑脊液鼻漏12例,垂体瘤44例,浆细胞瘤1例,圆柱瘤1例,内翻性乳头状瘤9例,骨纤维异常增殖症1例,鼻咽纤维血管瘤2例,侵入颅内的巨大蝶筛窦囊肿2例,孤立性蝶窦病变21例,视神经管骨折5例。结果脑脊液鼻漏12例全部修补成功。44例垂体瘤患者,术后结果优良35例,有效9例,无效0例。1例颅底巨大骨纤维异常增殖症以及1例浆细胞瘤、1例圆柱瘤、9例内翻性乳头状瘤均全切成功,随访1、2a无复发。2例鼻咽纤维血管瘤患者随访2a无复发。2例巨大蝶窦囊肿随访2a无复发。21例孤立性蝶窦病变术后主要症状全部消除。5例视神经减压手术术后4例视力恢复到0.2￣0.7,1例无明显改变。结论鼻内镜下处理颅底病变安全,效果确实,避免了外部切口的创伤。[Objective] To evaluate the value of endoscopic surgery of disease involving sinus and skull base. [Methods] We summarized retrospectively 98 eases of endoscopic surgery of disease involving sinus and skull base in which there were 12 eases of eerebrospinal rhinorrhea, 44 eases of pituitary adenomas, 1 ease of plasmaeytoma, 1 case of eylindroma, 9 eases of inverted papilloma, 1 case of large osteoma in the anterior skull base, 2 eases of nasopharyngeal angiofibroma, 2 eases of large sphenoethmoidal cyst involving cranum, 21 eases of isolated sphenoid lesions, 5 cases of optic canal fracture. [Results] All the cerebrospinal rhinorrhea were mended successfully. 35 of 44 pituitary adenomas had good results, 9 of 44 eases effective, and no invalid. The large osteoma and the plasmaeytoma, 1 ease of eylindroma, 9 eases of inverted papilloma were all excised successfully, and no recurrence for 2- years follow-up. There were no recurrence of the nasopharyngeal angiofibroma and the large sphenoethmoidal cyst for 2-years follow-up. The main symptoms of the isolated sphenoid disease had disappeared after surgery. 4 of 5 cases of optic canal fracture had better visual to 0.2-0.7; one case had no obvious change. [Conclusion] Endoscopic surgery was a safe, effective method for the lesions invoving the skull base.

关 键 词：鼻内镜 颅底 鼻窦 手术 外科 颅底疾病 

分 类 号：R765.2[医药卫生—耳鼻咽喉科] R765.9[医药卫生—临床医学]