侧颅底恶性肿瘤的手术治疗

The surgery treatment of lateral skull base malignant tumor

目的探讨侧颅底恶性肿瘤的理想手术入路和手术治疗价值。方法2000年1月至2002年1月,对27例侧颅底恶性肿瘤进行手术治疗。采用颞下窝入路7例、颈-下颌进路15例、上颌骨外翻入路2例、鼻侧切开加额眶颧颞联合入路3例。结果 全组27例肿瘤均完整切除,无手术死亡病例,术后暂时性偏瘫1例,术后脑脊液漏1例。随访到2003年5月,其1、2、3年生存率分别为1 00％(27/27)、86.4％(19/22)和70.0％(7/10),3年,无瘤生存率为60.0％。结论侧颅底恶性肿瘤的手术入路应视肿瘤部位而定,手术治疗有望改善患者的生存质量并延长患者的生命。

OBJECTIVE To study the eligible approach and the value of surgery treatment of malignant tumor in the lateral skull base. METHODS From Jan. 2000 to Jan. 2002, 27 cases with malignant tumor of the lateral skull base were treated by surgery. 15 cases were removed through transcervicomandibular approach, 7 cases transinfratemporal approach, 2 cases maxillary swing technique and 3 cases lateral rhinotomy combined with frontoorbito-zygomatic-tem-poral incision respectively. RESULTS All tumors were resected perfectly and no operative death.1 case with postoperative cerebrospinal fluid leak, and another with postoperative transient hemiplegia. In our study, the 3 years overall and tumor-free survival rates were 70.0 % and 60.0 % respectively. CONCLUSIONS The operative approach to resect the malignant tumor of the lateral skull base is decided by the site of the tumor. Surgery treatment may improve the life quantity of the patients and prolong their life span.