前颅底区恶性肿瘤的治疗——附17例报告  

TREATMENT OF MALIGNANT TUMOR ON THE PREBASICRANIAL REGION —— A REPORT OF 17 CASES

作　　者：朱力[1] 张虹[2] 陶远孝[2] 王菊仙[1] 

机构地区：[1]四川省攀枝花市攀钢总医院耳鼻喉科,中国四川攀枝花6170232 [2]四川省肿瘤医院颅底外,610041

出　　处：《中国耳鼻咽喉颅底外科杂志》1999年第4期220-223,共4页Chinese Journal of Otorhinolaryngology-skull Base Surgery

摘　　要：目的：探讨前颅底区恶性肿瘤的手术入路、修复方法和综合治疗。方法：１９９２～１９９８ 年６ 年间我们共收治的１７ 例前颅底区恶性肿瘤患者，９ 例采用了颅面眶联合进路的方法一次性完整切除肿瘤，并在术中采用了带蒂的颞肌肌瓣、颞肌筋膜瓣、帽状腱膜瓣、额肌肌瓣或肌皮瓣等＋ 骨板或＋ 游离植皮等方法，对前颅底区的组织缺损进行了一期修复，１３ 例手术前后辅以放射治疗和／ 或化学治疗。结果：存活５ 年以上５ 例（２９ ．４ ％ ） ，３ 年以上２ 例（１１ ．８ ％ ） ，２ 年以上４ 例（２３ ．５ ％ ） ，８ 个月以上３ 例（１７ ．６ ％ ） ，失访３ 例（１７ ．６ ％ ） 。结论：采用颅颌面、颅眶联合进路手术方法治疗前颅底区恶性肿瘤患者，能较彻底地切除肿瘤并方便修复；在术前后辅以放射治疗和化学治疗，可提高患者的生存率和生存质量。Objective: To study the operation approach, repair methods and comprehensive therapy for basicranial malignant tumor. Methods: During 1992~1998, 17 patients received complete tumor resection via the craniofacial and/or cephalo-orbital synchronous entrance. The following tissues were used for first-stage repair of tumor defects: temporal muscle flap with peducle fascial flap of temporal muscle, frontal muscle flap and musculo-cutaneous flap plus bone plate or free skin accordingly. Meanwhile, radiotherapy and chemotherapy were also undertaken preoperatively and postoperatively. Results: A follow up demonstrated that 5, 2, 4 and 3 patients lived longer than 5ys, 3ys, 2ys and 8 mths respectively; however, 3 patients were dropped out. Conclusion: In this way, the malignant tumor in the prebasicranial region can be completely resected, and the defects left can also be easily repaired. The comprehensive treatment with radiotherapy and chemotherapy pre and postoperatively can improve survival rates and living quality. [

关 键 词：肿瘤 前颅底区 外科手术 手术进路 

分 类 号：R739.410.5[医药卫生—肿瘤] R730.56[医药卫生—临床医学]