前颅底手术进路及其缺损修复方法的改进

Refinements in Both Approaches and Reconstructions for Skull Base Operation

本文介绍３０例前颅底手术，采取了鼻侧额下和鼻椎侧翻进颅入路，术野宽广、无角度、便于颅内病变切除，不牵拉额叶脑组织。用带蒂的全额肌皮瓣或颅骨骨膜瓣修复前颅底骨质缺损面积大于国外同类报道，不植骨，不加人工材料支撑，抗感染能力强，易成活，就近取材，操作简便，不会有死骨形成或排异反应，无长时间脑脊液漏。

cases with anterior skull base operation being done in our department were reported.The lateronasal- infrafrontal and lateraI nasal columella eversion approaches were refined t herein were shown to have the advantages of offering wide exposure,providing shortcut for reaching anterior cranial cavity and facilitating intracranial tumor extirpation without drawing away frontal lobe. The big bony defects of anterior skull base were recon-structed with total frontal musculocutaneous flap(8 cases)and pericranial flap(5 cases),which,as compased with either free bony graft or psosthesis are more resistant to infection.Besides,these flaps do have much higher survival chance and cause no rejection and os-teonecrosis,nor was these any persistant CSF leak.