鼻内镜下切除侵犯颅底与海绵窦的鼻咽纤维血管瘤二例临床分析  

Endonasal Endoscopic Approach for Resection of Nasopharyngeal Angiofibromas with Skull Base and Cavernous Sinus Invasion:Report of Two Cases

作　　者：磨宾宇[1] 孙文忠[1] 徐志文[2] 李杰恩[2] 温文胜[2] 

机构地区：[1]广西柳州市人民医院耳鼻咽喉科,545006 [2]广西医科大学第一附属医院耳鼻咽喉-头颈外科

出　　处：《中国全科医学》2011年第27期3143-3146,共4页Chinese General Practice

摘　　要：目的通过报道2例经鼻内镜下切除累及颅底、海绵窦的巨大鼻咽纤维血管瘤,探讨鼻内镜下切除该类肿瘤的可行性及手术方法。方法回顾性分析2例侵犯颅底、海绵窦的鼻咽纤维血管瘤患者的临床资料及治疗方案,结合相关文献分析该类型肿瘤的供血特点及鼻内镜的手术要点。结果 2例患者术前未行动脉血管栓塞,术中出血量分别为3 500 ml和3 000 ml,均获得一次性完整切除。分别随访15个月与11个月未见肿瘤复发。结论对于侵犯颅底、海绵窦及多重供血的鼻咽纤维血管瘤,可在充分的术前准备下行鼻内镜下手术切除。Objective To investigate the feasibility and surgical approaches of endoscopic resection of nasopharyngeal angiofibroma（NA） with skull base and cavernous sinus infiltration by reporting two typical cases.Methods Clinical features and therapeutic methods of the two cases of NA with skull base and cavernous sinus invasion were summarized.Charateristics of blood-supply and the key points of endonasal endoscopic approach were further reviewed.Results Intraoperative blood loss of the two cases was 3500 ml and 3000 ml respectively without preoperative artery embolization.Complete resection was performed in both cases.No tumor recurrence was observed during the subsequent follow-up for 15 or 11 months.Conclusion As for the treatment of NAs with skull base and cavernous sinus invasion supplied by multiple vascular branches,endoscopic surgery is effective on the premise of sufficient preoperative preparation.

关 键 词：鼻咽纤维血管瘤 内镜检查 颅底 海绵窦 

分 类 号：R766.3[医药卫生—耳鼻咽喉科]