颅内外沟通性嗅神经母细胞瘤8例显微手术治疗分析  

Microsurgical treatment of intracranial and extracranial communicative olfactory neuroblastoma in 8 cases

作　　者：李昊昱[1] 袁健[1] 彭刚[1] 谢源阳[1] 苏君[1] 刘庆[1] 袁贤瑞[1] 张弛[1] LI Haoyu;YUAN Jian;PENG Gang;XIE Yuanyang;SU Jun;LIU Qing;YUAN Xianrui;ZHANG Chi(Department of Neurosurgery,Institute of Skull Base Surgery and Neuro-Oncology of Hunan Province,Xiangya Hospital,Central South University,Changsha 410008,China)

机构地区：[1]中南大学湘雅医院神经外科湖南省颅底外科与神经肿瘤临床医疗技术研究中心,湖南长沙410008

出　　处：《中国耳鼻咽喉颅底外科杂志》2020年第2期131-134,共4页Chinese Journal of Otorhinolaryngology-skull Base Surgery

基　　金：湖南省2020年自然科学基金优青项目(2020YQ130);中南大学湘雅医院青年科研基金(2019Q15)。

摘　　要：目的讨论颅内外沟通性嗅神经母细胞瘤(ONB)的临床特点及显微手术策略。方法湘雅医院神经外科2013年1月-2019年6月收治的颅内外沟通性ONB患者8例,男5例,女3例,年龄13~65岁;病程7 d至5年,平均12个月。其中手术选择双侧扩大经额底入路5例,联合经鼻内镜3例。全部患者术后行放疗,2例辅助化疗。观察患者的手术策略和临床疗效。结果8例患者颅内外沟通性ONB全切除,术后头痛及鼻腔疼痛全部改善,随访7个月至6年,存活4例,失访2例,2例术后4~10个月肿瘤广泛复发导致死亡。结论双侧扩大经额底入路及联合经鼻内镜显微手术有助于颅内外沟通性ONB的全切除,可提高患者生存率,值得临床推广。Objective To summarize the clinical characteristics of and microsurgical treatment strategies for intracranial and extracranial communicative olfactory neuroblastoma.Methods Eight patients suffering from intracranial and extracranial communicative olfactory neuroblastoma were surgically treated in our department between Jan 2013 and July 2019. Of them, five were male and 3 were female with age ranged from 13 to 65 years old and disease course from 7 days to 5 years. Microsurgical treatment was performed via extendend bilateral transfrontal approach in 5 and endoscope-assisted transnasal approach in 3. All patients received postoperative radiotherapy, and 2 received adjuvant chemotherapy. The clinical characteristics of and microsurgical treatment strategies for this tumor were analyzed.Results Total tumor resection was achieved in all 8 patients with alleviation of headache and nasal pain. Followed up for 7 months to 6 years, 4 patients survived, 2 lost contact, and 2 died from extensive tumor recurrence in 4 to 10 months after surgery.Conclusion Both extendend bilateral transfrontal approach and endoscope-assisted transnasal approach benefit total resection of intracranial and extracranial communicative olfactory neuroblastoma and increase the cure rate, and therefore are worthy of clinical promotion.

关 键 词：嗅神经母细胞瘤 鼻 颅底外科 手术 治疗 

分 类 号：R765.9[医药卫生—耳鼻咽喉科]