经上颌骨翻转入路手术切除斜坡脊索瘤

Transmaxillary approach for surgical removal of clival chordomas

目的探讨采用经上颌骨翻转入路手术切除Al-MeftyⅢ型斜坡脊索瘤的方法及临床意义。方法对8例Al-MeftyⅢ型斜坡脊索瘤病人采用经上颌骨翻转入路行手术切除。结果均达到显微镜下肿瘤全切除。术后随访2￣50个月,平均27个月;1例发现有肿瘤复发,但生活质量良好,余病人无复发。手术并发症包括创腔感染1例,咽喉部肿胀致阻塞性通气困难1例,均治愈。结论经上颌骨翻转入路手术切除Al-MeftyⅢ型斜坡脊索瘤具有显露充分,肿瘤切除彻底,不损伤脑组织等优点。

Objective To study the method and clinical significance of transmaxillary approach for surgical removal of Al-Mefty type Ⅲ clival chordomas. Methods Eight patients with Al-Mefty type Ⅲ clival chordoma were treated by transmaxillary approach for surgical removal of the tumors. Results Total removal of the tumors was achieved microscopically in all the patients. The patients were followed up from 2 to 50 months, averaged 27 months. No recurrence occurred but one who has good living quality. The postoperative complications included infection and postoperative obstructive dyspnoea in 1 each, both of which were cured. Conclusion Better exposure,complete removal of tumors and less injury of the brain could be achieved by transmaxillary approach for surgical removal of Al-Mefty type Ⅲ clival chordomas with good effects.