上颌骨翻转入路手术切除侵及斜坡肿瘤  

Maxillary translocation approach for surgical removal of tumors invading clivus

作　　者：张黎[1] 郭京[1] 祁永发[2] 徐振纲[2] 刘少岩[2] 

机构地区：[1]卫生部中日友好医院神经外科,北京100029 [2]中国医学科学院附属肿瘤医院头颈外科

出　　处：《中华神经外科杂志》2006年第5期286-289,共4页Chinese Journal of Neurosurgery

摘　　要：目的探讨采用上颌骨翻转入路手术切除侵及斜坡肿瘤的疗效及临床意义。方法 31例侵及斜坡肿瘤患者,均采用上颌骨翻转入路手术切除。结果 31例患者均达到显微镜下肿瘤全切除,全部患者获2-80个月随访,平均随访26个月,因肿瘤复发死亡5例,与肿瘤无关死亡2例,带瘤生存5例,其余均无肿瘤复发,生活质量良好。手术并发症包括:创腔感染2例,保守治疗治愈;患侧听力下降2例;脑脊液漏1例;张口受限1例;1例术后出现咽喉部肿胀致阻塞性通气困难,行气管切开呼吸机辅助呼吸,7d后好转脱机拔管。结论上颌骨翻转入路手术切除侵及斜坡肿瘤具有显露充分、肿瘤切除彻底的优点,疗效满意。Objective To study the effectiveness and clinical significance of maxillary approach for surgical removal of tumors invading clivus. Methods 31 cases of clival tumors were treated by maxillary approach for surgical removal. Results Total removal of tumors was achieved in all patients. All patients were followed up from 2 to 80 months （mean duration： 26 months）. 7 patients died during the follow-up period （5 due to the recurrence of tumors and 2 due to other causes）. There were no recurrence in 19 patients with good living quality. The postoperative complications included： 2 case of infection, 1 case of postoperative obstructive dyspnoea, 1 case of cerebrospinal fluid leakage, all recovered; 2 cases of decreased hearing ability; 1 case of decreased ability of opening mouth. Conclusions Good exposure and complete removal of tumors could be achieved by maxillary translocation approach for surgical removal of tumors invading to clivus with good outcome.

关 键 词：斜坡 肿瘤 神经外科手术方法 

分 类 号：R730.5[医药卫生—肿瘤]