鼻内镜下前颅底病变手术治疗16例临床观察  

Clinical observation of endoscopic transnasal surgery for anterior skull base lesion in 16 cases

作　　者：吕洁瑜[1] 何炽辉 黄戈[2] 章晓军[1] 张卓成[1] 

机构地区：[1]广东省江门市中心医院耳鼻咽喉科,江门529000 [2]广东省江门市中心医院神经外科,江门529000

出　　处：《中国眼耳鼻喉科杂志》2016年第1期36-39,共4页Chinese Journal of Ophthalmology and Otorhinolaryngology

摘　　要：目的探讨鼻内镜技术在治疗前颅窝病变的应用、疗效和安全性。方法回顾分析2010年8月～2013年8月在本院耳鼻喉科和神经外科收治的16例前颅窝病变患者的临床资料,其中脑脊液修补3例,鼻窦非肿瘤病变侵犯前颅窝8例（鼻窦巨大囊肿侵犯前颅窝3例、鼻窦真菌感染1例、前颅窝异物1例、颅脑手术后前颅窝并鼻窦感染3例）,良性肿瘤4例（鼻窦乳头状瘤3例、复发性脑膜瘤1例）,恶性肿瘤1例（嗅母细胞瘤1例）。13例在鼻内镜下行手术治疗,3例行鼻内镜和颅面联合进路治疗。结果良性病变和良性肿瘤术后以鼻内镜和磁共振复查均未见复发。随访1～3年。1例恶性肿瘤术后放疗,目前随访2年未见复发。所有病例术后均未出现颅内感染、脑脊液漏等严重并发症。结论鼻内镜对于前颅窝良性病变和良性肿瘤处理适应证较广泛且疗效确切、安全;在适应证选择合理的前提下能安全、有效处理该部位的恶性肿瘤。Objective To study the feasibility, effect and safety of endoscopic transnasal surgery for anterior skull base lesion. Methods Sixteen cases affected with anterior skull diseases who had been hospitalized from August 2010 to August 2013 were reviewed. The lesions included 3 cases of cerebrospinal fluid leakage , 3 eases of giant mucocele of the nasal sinus, one case of fungal infection in paranasal sinuses, one case of foreign matter in anterior skull base ,3 cases of sinusitis with infection of anterior skull base after transfrontal eraniotomy, 3 cases of papilloma in sinnus, one case of recurrent meningioma and one ease of esthesioneuroblastoma. Thirteen of the cases underwent endoscopic transnasal surgeries. Three cases were treated with transnasal surgery and transbasal surgery. Results M1 the benign diseases and the benign tumors were cured and the patients were followed up for one to three years. One patient of the mild tumor had radiotherapy after the operation. No evidence proved to be recurred within the following 2 years. No serious complications such as intracranial infection,cerebrospinal fluid leakage occurred after the operation. Conclusions Endoscopic transnasal surgery for benign diseases and benign tumors in the anterior skull base is feasible and safe. But the surgical indication of the mild diseases must be controlled seriously.

关 键 词：内镜 前颅窝 外科手术 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]