颞下窝大型血管纤维瘤的诊治探讨

A Study of Diagnosis and Treatment of Angiofibroma Intruded into Infratemporal Fossa

目的:探讨突出面颊部血管纤维瘤的诊断和治疗方法。方法:回顾性分析1994年1月至2003年10月间在我科接受治疗的5例血管纤维瘤患者临床资料。术前行单侧选择性动脉栓塞或术中控制性低血压麻醉,手术均经口内上颌窦径路。结果:5例患者手术顺利,术后病理诊断均为血管纤维瘤。术后经2～24月随访,5例患者均咬合良好,无肿瘤复发。结论: CT、MRI和IADSA联合检查对诊断有较大价值。术前IADSA加动脉内栓塞可大大减少术中出血。经上颌窦径路是处置侵入翼腭窝、颞下窝的巨大血管纤维瘤的较好手术进路之一。

Objective: To explore the diagnosis and treatment of angiofibroma protruded the face. Methods: Five patients with nasopharyngeal angiofibroma were treated by surgery in our department from January 1994 to October 2003. The patients had the application of hypotensive anesthesia, or unilaterally superselective artery preoperative embolization. The operative approach through the maxillary sinus was applied to removing tumor. Results: Five patients were cured and their diagnosis of pathology were all angiofibromas. They all occluded well and had not tumor recurrence after following up from 2 to 24 months. Conclusion: CT, MRI and IADSA may all have a high value in the diagnosis of angiofibroma. Preoperative embolization could reduce bleeding and increase the safety of the operation. Operation through maxillary sinus is one of the effective treatment methods for nasopharyngeal angiofibromas intruded into pterygopalatine and infratemopral fossae.