上颌骨外旋切除前中颅底肿瘤  

Surgery treatment by upper maxillary swing technique for anterior and middle skull base neoplasms

作　　者：王天铎[1] 李梅[1] 姜玉芳[1] 陈瑛[1] 许安廷[1] 张大良[1] 董频[1] 李学忠[1] 

机构地区：[1]山东医科大学附属医院耳鼻咽喉科,250012

出　　处：《耳鼻咽喉（头颈外科）》1998年第4期195-200,共6页Chinese Arch Otolaryngology-Head Neck Surg

摘　　要：目的:探讨切除前、中颅底肿瘤的手术入路方式。方法:对9例患者(良性6例,恶性3例)分别采用上颌骨切开上部外旋切除肿瘤5例,上颌骨切开下部外旋2例及上颌骨切开外侧部外旋和上颌骨切开全外旋切除肿瘤各1例。与颅内贯通的4例中有2例合并其他入路成功地切除了肿瘤的颅内部分。结果:9例中1例脑膜瘤因累及海绵窦,切除时海绵窦处肿瘤有残瘤,术后1年半复诊该处肿瘤有所发展。1例低度恶性纤维组织细胞瘤,患者术后脑脊液鼻漏,1个月后死于颅内感染。余者随访最长者2年2个月,最短半年。结论:认为上颌骨切开外旋是切除前、中颅底肿瘤的宽广直接的理想入路,既利于肿瘤的整块切除,又便于颅底缺损的整复。Nine neoplasms involving the anterior and middle skull base were removed respectively using upper maxillary swing, lower maxillary swing, lateral maxillary swing & total maxillary swing method. 4 neoplasms extending intracranially, two of which were removed with combination of other techniques successfully. The pathology of the neoplasms included benign tumours such as meningioma, fibrous cell tumour, neurofibroma, cavernous angioma, and malignent lesions such as fibrosarcoma, lower grade malignent fibrous cell tumour, low and middle differentiated squamous cell carcinoma. The preoperation examinations, indications, surgical techniques, advantage and some relvent problems are discribed and discussed in details. It is experienced that the maxillary swings provide maximum direct exposure of anterior and middle skull base offering the potential for en bloc resection of many lesiones and facilitate skull base reconstruction. [Chinese Arch Otolaryngol Head Neck Surg, 1998; 5 (4): 195～200 From the Department of Otolaryngology, Affiliated Hospital of Shandong Medical University, Jinan 250012 (Dr. Wang Tianduo)]

关 键 词：上颌骨 肿瘤切除 颅底肿瘤 外科手术 治疗 

分 类 号：R739.410.5[医药卫生—肿瘤]