颅中窝内外沟通性肿瘤的显微外科治疗(附16例分析)  

Microsurgery for intra and extra middle skull base tumors: analysis of 16 cases

作　　者：樊丰势[1] 王政刚[1] 张旭东[1] 张卫宁[1] 程建业[1] 王帅[1] 齐洪武[1] 赵亚鹏[1] 刘艳宁[1] 李晓明[2] 

机构地区：[1]中国人民解放军白求恩国际和平医院神经外科,河北石家庄050082 [2]中国人民解放军白求恩国际和平医院头颈外科,河北石家庄050082

出　　处：《中国微侵袭神经外科杂志》2008年第5期210-212,共3页Chinese Journal of Minimally Invasive Neurosurgery

摘　　要：目的总结颅中窝内外沟通性肿瘤的显微外科治疗经验。方法回顾性分析16例颅中窝内外沟通性肿瘤病人的显微外科治疗经验。单纯采取额颞颧入路切除肿瘤13例,联合上颌窦前入路1例,联合下颌骨截断外旋2例。结果肿瘤全切除12例,次全切除4例。术后近期并发症:脑神经损伤6例,脑脊液漏2例,咬合错位2例,及伤口感染1例。无手术死亡。结论颅中窝沟通性肿瘤主要采用额颞颧手术入路切除,术中将颧弓断离,切除髁状突,释放脑脊液以降低颅内压,结合显微外科良好的照明、灵活的头位变换,可以较好地暴露并切除肿瘤。肿瘤广泛累及咽旁间隙时,可截断下颌骨扩大后部视野,保证手术安全。Objective To explore the experiences of microsurgery for intra and extra middle skull base tumors. Methods Clinic data from 16 patients with intra and extra middle skull base tumors were analyzed retrospectively. The tumor was removed via frontotemporalzygomatic approach） in 13 cases, and in combination with Caldwell-Luc approach in 1, and with mandibular swing approach in 2. Results Tumor was totally removed in 12 cases, and subtotally in 4. The early postoperative complications included the cranial nerves injury in 6 cases, cerebral spinal leakage in 2, malocclusion in 2, and wound infection in 1. There was no operative mortality. Conclusion The frontotemporal-zygomatic approach is a better way for resection of intra and extra middle skull base tumors. During the operation, tumor can be revealed and resected by cutting off the mandibular condyle, draining the cerebrospinal fluid for lowering intracranial pressure, in combination with the excellent visualization of the tumor and change of the head position. If the tumor invades the parapharygeal space and nearby vital structures, or the maxillary sinus, the combined approaches including cutting off the mandibular bone, is indicated.

关 键 词：颅窝 中 沟通性肿瘤 显微外科手术 

分 类 号：R739.4[医药卫生—肿瘤]