扩大Le FortⅠ型截骨入路在切除颅底肿瘤中的应用

The application of extended approach for Le Fort I osteotomy in the removal of skull base tumor

目的探讨扩大LeFortⅠ型截骨入路切除颅底斜坡区及鼻咽部和蝶窦区肿瘤的疗效。方法以扩大LeFortⅠ型截骨入路对14例该区域的肿瘤进行手术切除,其中脊索瘤9例,软骨瘤2例,垂体瘤、转移癌、骨纤维结构不良各1例。结果颅底肿瘤全切除11例,次全切除3例;上颌骨复位后,咬合关系均恢复良好。随访12￣24个月,4例局部复发,其余恢复良好。结论采用扩大LeFortⅠ型截骨入路切除颅底肿瘤,较传统前方或侧方入路对脑组织损伤小,手术视野暴露清楚,无严重及长期并发症。

Objective To study the therapeutic effect of extended approach for Le Fort Ⅰ osteotomy in removal of tumors in the clival region of the skull base and nasopharyngeal and sphenoidal sinus regions as well. Methods The approach was applied in resecting the tumors of these regions in 14 cases, which including 9 chordoma, 2 chondroma, 1 pituitary adenoma, 1 metastasis of carcinoma and 1 bone fibrous dysplasia. Results The tumors were completely removed in 11 cases, and subtotally in 3. Follow-up ranged from 12 to 24 months, the patients had a good recovery but 4 relapse cases. Conclusion In comparison with the classic approach, the extended approach for Le Fort Ⅰ osteotomy can provide a better way to resect the tumor in the clival region of the skull base with clear surgical view and minimal invasion, and without serious complications.