扩大鼻外额筛窦进路切除额眶筛区肿瘤  

Resection the tumor in fronto-orbito-ethmoidal region via extend external frontal and ethmoidal sinus approach

作　　者：孙慧如[1] 娄卫华[1] 王亮[1] 

机构地区：[1]郑州大学第一附属医院耳鼻咽喉头颈外科,河南郑州450052

出　　处：《中国耳鼻咽喉头颈外科》2006年第11期740-742,共3页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：河南省高校杰出科研人才创新工程基金(2003kycx009)

摘　　要：目的探讨额眶筛区肿瘤切除的手术入路。方法于患侧行扩大鼻外额筛窦进路,根据肿瘤范围大小向鼻侧或沿眉弓向外延长切口,可充分暴露前颅底、额眶筛区甚至眶外上缘区域肿瘤。结果自1998年1月～2003年12月收治的累及前颅底额眶筛区的肿瘤28例使用上述术式。经随访,其中8例良性肿瘤至今无复发,20例恶性肿瘤中,1年生存率95%(19/20),3年生存率61．5%(8/13),5年生存率57．1%(4/7)。结论该术式术野暴露充分,出血少,手术视野清晰,操作方便,切除肿瘤彻底,重建颅底方便,手术创伤小,术后反应轻。该术式是切除前颅底额眶筛区肿瘤的较好手术入路。OBJECTIVE To introduce a better surgical approach for resection the tumor in the fronto- orbito-ethmoidal region. METHODS Extend external frontal and ethmoidal sinus approach was used in the unhealthy side. The incision can be extended to the nasal side or outward to the superciliary arch according to the tumors extent and size so as to get a full exposure of tumors in the anterior skull base, fronto-orbito-ethmoidal region, or exterior superior margin of the orbit. RESULTS From Jan. 1998 to Dec. 2003, 28 patients suffered from tumors in the anterior skull base and orbito-ethmoidal region received tumors resection through this approach. Postoperatively, no death or recurrence occurred up to now in 8 cases with benign tumors. The 1-, 3- and 5- year survival rate was 95 %（19/20）, 61.5 %（8/13）and 57.1%（4/7） respectively in 20 cases with malignant tumors. CONCLUSION This approach provide good exposure and has the advantages of little bleeding, clear operation field, easy to operate, convenient to re-establish skull base, less surgical trauma and mild reaction. We believe this approach is a better method for resection of tumors in anterior skull base and the fronto-orbito-ethmoidal region.

关 键 词：额 眼眶 筛骨 颅底 肿瘤 外科手术 

分 类 号：R730.5[医药卫生—肿瘤]