经改良Derome入路切除前颅底沟通肿瘤  

The modified Derome' approach for resection of anterior skull base communicating tumors

作　　者：周平平[1] 万经海[1] 孟肖利[1] 钱海鹏[1] 李学记[1] 吴跃煌[2] 

机构地区：[1]北京协和医学院中国医学科学院肿瘤医院神经外科,北京100021 [2]北京协和医学院中国医学科学院肿瘤医院头颈外科,北京100021

出　　处：《转化医学电子杂志》2017年第2期34-36,共3页E-Journal of Translational Medicine

摘　　要：目的:探讨经改良Derome入路显微镜下切除前颅底沟通肿瘤的手术方法.方法:回顾总结经改良Derome入路显微镜下切除前颅底沟通肿瘤38例的手术经验.结果:良性肿瘤15例,恶性肿瘤23例;肿瘤全切除32例(84.2%),次全切除6例(15.8%),并发症发生率为31.6%(12/38),无手术死亡病例.38例患者中,2例失访,其余36例随访时间为2~89月,恶性肿瘤的5年生存率为66.2%.结论:经改良Derome入路可一期根治性切除前颅底沟通肿瘤;采用颞肌筋膜及带血管蒂额肌骨膜瓣双层修复颅底可减少术后脑脊液漏及颅内感染等严重并发症.AIM： To explore the surgical method of the modified Derome’ approach for resection of anterior skull base communicating tumors. METHODS： A total of 38 patients of anterior skull base communicating tumor treated microsurgically were analyzed retrospectively. RESULTS： A total of 15 patients had benign and23 patients had malignant tumor. Total resection was achieved in32 patients（ 84.2%）,subtotal resection in 6 patients（ 15. 8%）.The incidence of complications was 28.9%（ 11 / 38）,no surgical death occurred. 36 patients were followed up for a period from 2 to89 months,and 2 patients were lost to follow-up. For patients with malignant tumors,5-year survival rate was 66. 2%. CONCLUSION： The modified Derome’ approach for resection of anterior skull base communicating tumor is fit for one-stage radical resection. Reconstruction of the skull base with both temporalis myofascial flap and pedicled frontal muscle periosteous flap can obviously decrease the complications rate,such as cerebrospinal fluid leakage and intracranial infection.

关 键 词：前颅底 沟通肿瘤 改良Derome入路 

分 类 号：R735.2[医药卫生—肿瘤]