显微神经外科联合鼻内窥镜技术一期手术治疗颅鼻沟通性肿瘤

Micro-neurosurgical Treatment of Cranionasal Tumors in Combination with Transnasal Endoscopy

目的探讨颅鼻沟通性肿瘤的外科治疗。方法回顾性分析四川大学华西医院神经外科2005年6月至2007年6月手术治疗的18例颅鼻沟通性肿瘤。结果本组18例均行开颅联合鼻内窥镜手术,一期手术切除肿瘤并行颅底重建。手术全切14例,次全切除4例,术后发生一过性脑脊液漏2例,18例患者均恢复良好,本组无手术死亡病例。随访5月-2年半,4例复发,3例失访,其余11例存活良好。结论显微神经外科联合鼻内窥镜技术一期手术治疗颅鼻沟通性肿瘤,可以较安全彻底地切除肿瘤并稳妥地进行颅底重建,手术全切率高,并发症率低。

Objective To explore an effective microsurgical approach to the treatment of cranionasal tumors. Methods A retrospective review of 18 micro-neurosurgical patients with cranionasal tumors （June 2005 to June 2007） was undertaken. Results All of the 18 patients were treated with subfrontal approaches in combination with transnasal endoscopy. Tumors were resected in the stage-one operations （14 were totally resected and 4 were subtotally resected）. The anterior skull bases were reconstructed. Transient CSF rhinorrhea was found in two cases. All of the patients experienced good recoveries, with no operative death. The follow up after 5 to 29 months revealed that only four patients had tumor recurrence. Three patients lost in the follow up. Conclusion Subfrontal microsurgical operation combined with transnasal endoscopy is an effective approach to the treatment of cranionasal tumors. It enables high total resection rate and has low complications.