改良上颌骨拆装术治疗前中颅底肿瘤

Surgical treatment of tumors in anterior and middle skull base by modified maxillay bone disassembly procedures

目的探讨改良上颌骨拆装术在治疗前中颅底肿瘤中的应用。方法回顾性分析采用改良上颌骨拆装手术入路方式切除前中颅底肿瘤10例。其中良性肿瘤9例,恶性肿瘤1例。观察术后疗效,并对10例患者进行术后12个月到5年的随访。结果根据肿瘤性质、大小及位置的不同而采用改良上颌骨拆装手术入路方式完整切除肿瘤。患者术后生活质量明显提高,9例良性肿瘤术后无复发,术后2例发生脑脊液鼻漏,7d后自愈。1例恶性肿瘤患者术后1年死于脑转移。结论术前对肿瘤情况进行充分的评估,根据具体情况选择距离肿瘤最近、能充分暴露肿瘤的改良上颌骨拆装入路,不仅可以完全切除肿瘤,而且创伤小,患者术后生活质量得到提高。

Objective To explore the therapeutic effect of the modified maxillay bone disassembly procedures on patients with tumors in the anterior and middle skull base. Methods Retrospective analysis was made of patients treated with the modified maxillay bone disassembly procedures. Ten tumors in the anterior and middle skull base were resected according to the pathology, size and site of the skull base tumors including 9 benign tumors and 1 malignant tumor. Results All tumors were resected completely. All patients were followed up from 12 months to 5 years postoperatively. The complications were less and the life quality was increased. The patients with benign tumors showed no recurrence . Two patients with cerebrospinal rhinorrhea cured spontaneously after 7 days. One patient with melanoma died of brain metastase. Conclusions It is necessary to estimate the tumors thoroughly before surgery. According to the location of the tumor, the modified maxillay bone disassembly is the nearest and harmless approach, through which the tumors can be completely excised with minimal invasiveness. The life quality is thus increased.