颅底内外沟通瘤的临床分析  

Clinical analysis of intra-and extra-cranially communicating tumors

作　　者：姚林 冯鸣[1] 王中[1] 周幽心[1] 周岱[1] YAO Lin;FENG Ming;WANG Zhong;ZHOU You-xin;ZHOU Dai(Department of Neurosurgery,The First Affiliated Hospital,Soochow University,Suzhou 215006,China)

机构地区：[1]苏州大学附属第一医院神经外科

出　　处：《中国临床神经外科杂志》2020年第1期13-15,共3页Chinese Journal of Clinical Neurosurgery

摘　　要：目的探讨颅底内外沟通瘤的临床表现、影像学表现、治疗方案及预后情况。方法回顾性分析2013年1月至2018年8月手术治疗的48例颅底内外沟通瘤的临床资料。肿瘤主体位于颅前窝20例、颅中窝19例、颅后窝9例。结果肿瘤全切除30例,次全切除10例,部分切8例。无围手术期死亡。术后出现脑脊液漏6例,颅内感染5例,新发颅神经损伤5例。术后病理示良性肿瘤37例,恶性肿瘤11例。2例失访,其余46例术后随访3~50个月,平均20月;34例未见复发,6例死亡,6例术后复发再次手术。结论颅底内外沟通瘤解剖层次复杂,需联合多学科诊治,手术并发症多,术中应保护血管、神经,同时需重视颅底修复和重建,术后根据肿瘤病理类型制定放、化疗方案。Objective To investigate the clinical symptoms, imaging findings, treatment and prognosis in the patients with intraand extra-cranially communicating tumors. Methods The clinical data of 48 patients with intra-and extra-cranially communicating tumors, who underwent surgery in our department from January, 2013 to August, 2018, were analyzed retrospectively. Of 48 patients with age range from 22 to 79 years, 22 were male and 26 female,. The size of tumors ranged from 3.5 cm to 10.0 cm. According to the location of the main body of the tumor, there were 20 cases of the tumors were in the anterior cranial fossas, 19 in the middle cranial fossas and 9 in the posterior cranial fossas. Results The tumors were totally resected in 30 patients, subtotally in 10 and partially in 8. No patients died during the perioperative period. The cerebrospinal fluid leakage occurred in 6 patients, intracranial infection in 5, and new cranial nerve injury in 5. The histopathological examination showed that 37 cases of tumors were benign and 11 were malignant. Forty-six patients were followed up for 3~50 months(mean, 20 months). The tumors did not recur in 34 patients and the tumors recurred after the operation in 6 patients and 6 died. Conclusions The anatomy of intra-and extra-cranial communicating tumors is complex, and their diagnosis and treatment need multidisciplinary cooperation. There are many complications after the operation. The blood vessels and nerve should be protected during the operation, and the skull base should be repaired and reconstructed. Postoperative radiotherapy and chemotherapy protocols were established according to the tumor pathological types in the patients with intra-and extra-cranially communicating tumors.

关 键 词：颅内外沟通瘤 手术治疗 颅底重建 

分 类 号：R739.41[医药卫生—肿瘤] R651.11[医药卫生—临床医学]