蝶窦区病变外科手术径路之探讨——附50例报告  

Exploration of surgical approach of the lesion of sphenoid sinus field——Report of 30 cases

作　　者：甄泽年[1] 赵敏[1] 陈辉[1] 李建忠[1] 

机构地区：[1]福州市南京军区福州总医院耳鼻咽喉科,350025

出　　处：《耳鼻咽喉（头颈外科）》2002年第2期75-76,共2页Chinese Arch Otolaryngology-Head Neck Surg

摘　　要：目的:探讨切除蝶窦区病变的良好手术径路。方法:根据病变种类的不同,分别采用:①用鼻内镜经单侧鼻腔入路治疗双侧蝶窦病变;②腭部粘膜“Ｔ”形瓣翻揭＋硬腭开窗入路;③扩大的鼻侧切开＋鼻锥翻揭入路;④颅面联合径路;⑤骨折外移鼻中甲行鼻中隔蝶窦入路。结果:本组５０例,术中视野较为开阔、清晰。因减少了手术盲目性,本组未出现医源性并发症。蝶窦区良性病变３７例中,术后随访３年未见复发;蝶窦区恶性肿瘤１３例中经随访,３年存活率为６１．５%(８/１３),５年存活率为４６．２%(６/１３)。结论:为了减少手术并发症,根据蝶窦的不同病变而采取不同的手术径路是合理的。ve: To explore the gdod surgical approaches of the dissection of the lesion in sphenoid sinus. Method: According to the type of the lesion,five surgical pathways were adopted;(1) Bilateral sphenoid sinus lesion was treated through single lateral nasal cavity pathway under the nasal endoscopy; (2) Hard palate windowing pathway by overturn of the 'T' form mucosa flap of palate;(3) Enlarged lateral rhinotomy and overturn of nasal pyramid pathway 5 (4) Combined cephalofacial approach; (5) Nasal septum sphenoid sinus pathway by fracturing and moving outwards the middle turbinate. Result:All of the 50 cases had a broad and clear surgical field. Because the blindness was minimized,no complication appeared. Of the 37 cases of benign primary lesions of sphenoid sinus,no recurrence was found. Of the 13 cases of malignant lesion of sphenoid sinus field, the three-year survival rate was 61. 5%(8/13) and the five-year survival rate was 46. 2%(6/13). Conclusion:In order to reduce the complication,it is reasonable to adopt different surgical approaches based on the type of the lesions.

关 键 词：蝶窦肿瘤 癌 外科手术 治疗 蝶窦区病变 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]