颅面联合进路手术治疗前颅底恶性肿瘤的临床研究  

Craniofacial approach for resection of malignant tumors involving the anterior skull base

作　　者：华清泉[1] 吴展元[1] 廖华[1] 

机构地区：[1]武汉大学人民医院耳鼻咽喉头颈外科,湖北武汉430060

出　　处：《中国耳鼻咽喉颅底外科杂志》2002年第3期145-147,共3页Chinese Journal of Otorhinolaryngology-skull Base Surgery

摘　　要：目的　总结前颅底手术的颅面进路与修复的经验 ,以提高病人生存率、生存质量 ,减少并发症。方法　采用颅面联合进路共行 31例前颅底恶性肿瘤切除手术并行颅底重建 ,其中 17例筛窦鳞癌、腺癌 ,5例未分化癌 ,3例肉瘤 ,6例嗅母细胞瘤。 31例恶性肿瘤中 2 7例辅以放疗。术后平均随访 5 8个月。结果　 31例恶性肿瘤中 18例存活未见复发 ,2例复发带瘤生存 ,11例死于原发病 ,术后平均生存时间 6 2个月。术后无严重并发症。结论　颅面联合进路手术相对安全、有效 ,但术者须掌握手术原则 ,熟悉颅底解剖 。Objective To review the experience with craniofacial approach for the removal of malignant tumors in the anterior skull base and the reconstruction of cranial base defects and to evaluate tumor control, survival rate and complications. Methods Tumor removal through combined craniofacial approach was achieved in 31 patients.Pathology included squamous cell carcinoma and adenocarcinoma of ethmoid sinus (n=17), sarcoma (n=3), olfactoryneuroblastoma (n=6), and undifferentiated carcinoma (n=5). Pedicled galeal-pericranial flap was used for soft-tissue coverage in the reconstruction of the cranial base defects. Twenty-seven out of the 31 patients received adjunit pre-postoperative radiotherapy with an average follow-up of 58 months. Results Fifty-eight percent (18/31) of the patients are free of diseases with a follow-up of 24～112 months. Two patients survived with tumor and 11 patients died of recurrence and metastasis of the tumor. There were no serious postoperative complications and a median survival of 62 months was obtained. Conclusion Combined craniofacial approach can provide a relatively safe and effective resection for malignant tumors in the anterior skull base with fewer complications and highter survival rate.

关 键 词：颅面联合进路 颅底手术 颅底恶性肿瘤切除 

分 类 号：R651.1[医药卫生—外科学] R739.4[医药卫生—临床医学]