11例侧颅底罕见肿瘤的临床分析  

Clinical Analysis of 11 Cases of Rare Tumors in the Lateral Skull Base

作　　者：朱晓丹[1] 叶放蕾[1] ZHU Xiaodan;YE Fanglei(Otology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学第一附属医院耳科,河南郑州450000

出　　处：《河南医学研究》2024年第7期1170-1174,共5页Henan Medical Research

摘　　要：目的总结以耳科症状为首发的侧颅底原发肿瘤的临床表现、影像学特点及诊疗方案,为临床诊疗积累经验。方法回顾性总结11例侧颅底肿瘤患者的临床资料,对其影像学表现、手术入路及术后随访结果进行分析。结果11例患者肿瘤侵犯范围主要包括颞骨鳞部、颞下窝、颞颌关节、中颅窝底、中耳等。采用颞下窝联合入路完整切除肿瘤,封闭外耳道。术后患者均无严重并发症。术后病理:弥漫性腱鞘巨细胞瘤3例,巨细胞修复性肉芽肿1例,软骨肉瘤1例,副神经节瘤1例,岩尖部胆脂瘤2例,面神经鞘瘤3例,均属于罕见肿瘤。8例随访超过1 a,1例复发,7例无复发,3例随访时间未超过1 a,随访时间内情况良好。结论高分辨颞骨CT及增强MRI对侧颅窝底肿瘤的病变范围和性质有良好的鉴别意义,术前仔细阅片可有效提高诊断率。针对肿瘤侵犯范围制定个性化手术方案。Objective To explore the clinical manifestations,imaging features and diagnosis and treatment of the primary tumors at the lateral cranial fossa base,so as to accumulate experience for clinical diagnosis and treatment.Methods The clinical data of 11 patients with lateral skull base tumor were retrospectively analyzed,and the imaging manifestations,surgical approaches and postoperative follow-up results were analyzed.Results The tumor invasion scope of 11 patients mainly included temporal bone scale,infratemporal fossa,temporomandibular joint and middle ear.The middle ear of 11 patients was obviously invaded.The tumor was completely removed through the combined approach of infratemporal fossa and the external auditory canal was closed.There were no serious complications after operation.Postoperative pathology:3 cases of diffuse giant cell tumor of the tendon sheath,1 case of giant cell repair granuloma,1 case of chondrosarcoma,1 case of paraganglioma,2 cases of petrous apex cholesteatoma,and 3 cases of facial neurilemmoma,all of which belong to rare tumors.Eight cases were followed up for more than 1 year,1 case recurred,7 cases had no recurrence,3 case was followed up for less than 1 year.They were in good condition during the follow-up time.Conclusion High resolution temporal bone CT and enhanced MRI have good significance in differentiating the lesion scope and nature of lateral skull base tumor,and careful preoperative examination can effectively improve the diagnostic rate.Personalized surgical plan should be made according to tumor invasion range.

关 键 词：侧颅底 肿瘤 巨细胞修复性肉芽肿 弥漫性腱鞘巨细胞瘤 岩尖胆脂瘤 软骨肉瘤 副神经节瘤 

分 类 号：R739.61[医药卫生—肿瘤]