经鼻内镜治疗蝶窦骨化纤维瘤  

Endoscopic surgical treatment of ossifying fibroma of sphenoidal sinus

作　　者：倪富强[1] 李红艳[1] 伊海金[1] 周晖[1] 刘丕楠[1] 

机构地区：[1]首都医科大学附属北京天坛医院耳鼻咽喉科,北京100050

出　　处：《中国耳鼻咽喉头颈外科》2009年第9期507-509,共3页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的探讨累及蝶鞍、斜坡、视神经管和颈内动脉的蝶窦骨化纤维瘤的微创外科治疗。方法总结2003年6月～2007年7月鼻内镜下切除累及蝶鞍、斜坡、视神经管和颈内动脉的蝶窦骨化纤维瘤8例。结果6例肿瘤全切,2例大部分切除。术后随访6个月至2年,全切除病例无一例复发,大部分切除病例残留肿瘤无明显增大。术后症状改善明显。未发生颅内感染。3例颅底缺损脑膜暴露者行人工脑膜加固,2例视神经暴露者用鼻腔黏膜覆盖,1例术中发生脑脊液漏者用大腿外侧肌肉筋膜修补,术后恢复良好。结论经鼻内镜治疗蝶窦骨化纤维瘤是一种损伤小、病变切除较为彻底的有效方法。但是要有良好的鼻内镜系统以及必要手术器械,术者要有颅底显微解剖知识和处理颅内外沟通性病变经验,同时具有熟练的内镜操作技术。OBJECTIVE To explore the microtrauma＇s method of surgical treatment of ossifying fibroma of sphenoidal sinuses involving sella turcica and clivus blumenbachii and optic canal and internal carotid artery.METHODS The clinical data of surgical treatment of ossifying fibroma of sphenoidal sinuses involving sella turcica and clivus blumenbachii and optic canal and internal carotid artery with nosal endoscope in 8 cases in 2003.06-2007.07 were retrospectively analyzed.RESULTS Six cases was whole resected and 2 cases was bulk resected.There was no recurrence whole resected cases and no obvious augmentation bulk resected cases followed up six months to 2 years.Symptom of all the patients was obvious improvement.There was no intracranial infeion of cases.Three skull bases defect was repaired by artificial meninges, 2 exposure optic nerve was coverage by nasal mucosa,1 nasal leakage of cerebrospinal fluid was repaired by fascia.CONCLUSION It is minimally invasive and efficiency of transnasal endoscopic technique for ossifying fibroma of sphenoidal sinuses. The satisfactory endoscope and operated tool and abundance knowledge in base of skull microdissection and masterly endoscopic technology are the key for successful operation.

关 键 词：蝶窦 纤维瘤 骨化性 内窥镜检查 

分 类 号：R739.62[医药卫生—肿瘤] R765.41[医药卫生—临床医学]