累及颅底肿瘤切除的两种途径  

Application of maxillary swing approach and parotid gland infratemporal fossa approach to the resection of skull base tumor

作　　者：薛桂平[1] 木合塔尔.霍加 多力昆.吾甫尔 李昊[2] 

机构地区：[1]上海同济大学附属同济医院口腔颌面外科,上海200065 [2]新疆维吾尔自治区人民医院附属口腔医院颌面外科,乌鲁木齐830001

出　　处：《复旦学报（医学版）》2009年第5期630-633,共4页Fudan University Journal of Medical Sciences

摘　　要：目的探讨完整而安全切除累及颅底区域肿瘤的两种手术径路。方法对4例颅底肿瘤根据侵及区域不同,采用不同的手术径路,其中3例采用经一侧上颌骨翻转入路,1例采用经一侧腮腺颞下窝入路。结果所有病例的颅底肿瘤均被安全而完整地切除,涉及的颅底区域包括颞下窝,翼腭窝,鼻咽部及咽旁间隙。病变包括纤维血管瘤,非霍奇金恶性淋巴瘤,高分化平滑肌肉瘤及高分化鳞癌。结论上颌骨掀翻入路是治疗中颅底或侧颅底,尤其是同时累及两个解剖区域以上病变时一种较好的选择。对于侧后颅底病变伴张口受限,面神经受侵犯者,经腮腺颞下窝入路是极好的选择。Objective To compare the application of transmaxillary approach and parotid gland infratemporal fossa approach to full and safe resection of skull base tumor. Methods We selected different approaches according to the different invasive positions in 4 cases of skull base tumor. Maxillary swing approach and parotid gland infratemporal fossa approach from one side were performed in 3 cases and 1 case, respectively. Results The 4 cases of tumors at skull base were removed safely and fully using approaches of transmaxillary and parotid gland infratemporal fossa. The lesion implicated infratempora[ fossa, pterygopalatine fossa nasopharynx, and parapharyngeal space and pathological changes were masopharyngear angiofibroma, leiomyosarcoma, non hodgkins lymphoma and squamous cell carcinomar. Conclusions The maxillary swing approach is proved to be a good access to the middle cranial base or lateral cranial base. Parotid gland infratemporal fossa is a better selection for the lesion at the posterior and lateral cranial fossa involving facial nerve and developing trismus.

关 键 词：上颌骨翻转入路 颞下窝入路 颅底肿瘤 外科手术 

分 类 号：R651.19[医药卫生—外科学] R739.8[医药卫生—临床医学]