经鼻内镜下鼻咽血管纤维瘤手术的探索  

Transnasal endoscopic surgery for juvenile nasopharyngeal angiofibroma

作　　者：孙敬武[1] 吕秋萍[1] 汪银凤[1] 王明善[1] 金自仓[1] 李显光[1] 万光伦[1] 

机构地区：[1]安徽省立医院耳鼻咽喉-头颈外科,合肥230001

出　　处：《安徽医学》2004年第2期98-99,共2页Anhui Medical Journal

摘　　要：目的　探索经鼻内镜下行鼻咽血管纤维瘤切除术。方法　 6例鼻咽血管纤维瘤术均于术前 1～ 7天行数字减影血管造影和瘤体供血动脉栓塞术 ,在控制性低血压全身麻醉下 ,经鼻内镜下切除 ,2例分别辅以上颌唇龈沟切口和面中部翻揭术。结果　 5例肿瘤在内镜下全部切除 ,1例翼腭窝内部分残留。术中平均出血 80 0ml,无并发症发生 ,平均随访 9个月 ( 2～ 19个月 ) ,1例翼腭窝内部分残留者复发。结论　内镜结合一些相关技术 ,可切除局限于鼻腔、鼻咽、鼻窦和翼腭窝的鼻咽血管纤维瘤 。Objective The purpose of this study is to review our experience and to define the indications and pitfalls of endoscopic excision of juvenile nasopharyngeal angiofibroma.Methods Six cases of juvenile nasopharyngeal angiofibroma were successfully managed between January,2001 and July, 2003 by preoperative selective embolization of the intermal maxillary artery, followed by endoscopic excision.Results No complications had occurred. Average intraoperative blood loss was 800 ml. Five patients remained free of disease after a median follow-up period of 9 months. Partial tumor tissue remained in pterygopalatine fossa in one case.Conclusion Juvenile nasopharyngeal angiofibroma is a highly vascular tumor arising from the area around the sphenopalatine foramen. Angiofibromas involving the nasopharynx, nasal cavity, and sphenoid with minimal lateral extension via the sphenopalatine foramen can also be adequately managed endoscopically. The transnasal endoscopic technique offers a minimally invasive resection of the entire tumor mass with minimal morphological disturbance.

关 键 词：鼻内镜 鼻咽血管纤维瘤 手术治疗 切除术 手术入路 

分 类 号：R739.6[医药卫生—肿瘤] R730.56[医药卫生—临床医学]