累及前颅底或颅内的鼻腔副鼻窦癌经颅面联合进路显微外科治疗的研究  

The Study of Microsurgery for the tumors of the nasal cavity and paranasal sinuses invading anterior skull base or intracranial tissue resected by combined craniofacial approach

作　　者：伍国号[1] 耿军[2] 陈福进[1] 曾宗渊[1] 闵华庆[1] 许光普[1] 魏茂文[1] 郭朱明[1] 

机构地区：[1]中山医科大学肿瘤防治中心头颈科,广东广州510060 [2]中山医科大学第一附属医院神经外科,广东广州510089

出　　处：《癌症》2000年第2期175-176,180,共3页Chinese Journal of Cancer

摘　　要：目的 :探讨累及前颅底或颅内脑组织的鼻腔副鼻窦癌的手术切除途径及方法。方法 :经颅面联合进路行显微外科连续整块切除累及前颅底或颅内脑组织的鼻腔副鼻窦癌 15例 ,其中 5例仅累及前颅底 ,10例累及前颅底至颅内额叶脑组织。硬脑膜缺损应用大腿阔筋膜修补。结果 :15例均作了术后随访 ,随访时间最长为 10年 ,最短为 2年。其中 4例为初治患者 ,11例为综合治疗后局部复发患者。 9例无瘤生存 2年以上 ,2年无瘤生存率为60 .0 0 %。 11例接受此手术行拯救外科治疗 ,其中 6例无瘤生存 2年以上 ,2年拯救成功率为 5 4 .5 5 %。结论Objective: To investigate the approach and resection technique for the tumors of nasal cavity and paranasal sinuses invading the anterior skull base or the intracranial brain tissue. Method: Fifteen patients were operated for the tumor of nasal cavity and paranasal sinuses involving the anterior cranial base or the intracranial tissue through conbined craniofacial approach with en bloc microsurgical resection. Among them, five cases had the cancer involving the anterior cranial base and ten cases involving the intracranial tissue through the anterior cranial base. The dural defects resulted from resection were repaired with femoral fascia. Results:Fifteen cases have been followed up 2 10 years since the operation. There were 9 patients (60%) have been tumor free survival for 2 years. Eleven patients underwent the operation for salvaged surgery. Among them 6 cases have been tumor free for more than 2 years.The 2 year successuful rate for salvaged surgery was 54.55%. Conclusion:It is feasible to remove the tumors of the nasal cavity and paranasal sinuses invading anterior cranial base or the intracranial tissue through combined craniofacial approach with en bloc resection microsurgically. Key words: Nasal cavity and paranasal sinuses; Tumour; Skull base; Microsurgery。矗恚? ａｎｄ １％ ｌｉｄｏｃａｉｎｅ ８ｍｌ．Ｉｎ ｇｒｏｕｐ Ｂ（ｃｏｎｔｒｏｌ），ｅｐｉｄｕｒａｌ ｉｎｊｅｃｔｉｏｎ ｗａｓ ｍａｄｅ ｏｎｃｅ ｐｅｒ ｗｅｅｋ ｗｉｔｈ １％ ｌｉｄｏｃａｉｎｅ．Ｔｈｅ ａｎｅｓｔｈｅｔｉｃ ｏｎｓｅｔ，ｒａｎｇｅ ａｎｄ ｄｅｇｒｅｅ ｗｅｒｅ ｏｂｓｅｒｖｅｄ ｉｎ ｔｈｅ ｔｗｏ ｇｒｏｕｐｓ．Ｆｕｒｔｈｅｒｍｏｒｅ，ｔｈｅ ｒｏｅｎｔｇｅｎｏｇｒａｐｈｙ ｏｆ ｅｐｉｄｕｒａｌ ｓｐａｃｅ ａｎｄ ｂｉｏｐｓｙ ｏｆ ｅｐｉｄｕｒａｌ ｔｉｓｓｕｅｓ ｗｅｒｅ ｍａ�

关 键 词：鼻腔副鼻窦癌 显微外科手术 手术进路 

分 类 号：R739.62[医药卫生—肿瘤]