多学科联合治疗颅鼻沟通性肿瘤

Multi-disciplinary Cooperation in Management of Cranionasal Tumors

目的：探讨颅鼻沟通性肿瘤的诊断与显微外科治疗。方法：回顾性分析四川大学华西医院神经外科2004年6月～2006年1月手术治疗的17例颅鼻沟通性肿瘤。结果：本组17例病变均经鼻腔内镜辅助下行额下入路,一期手术切除并行颅底重建。手术全切14例,大部切除3例,均恢复良好,2例术后发生脑脊液漏,发生率11.8%。无死亡病例。病理结果：脑膜瘤8例（其中不典型脑膜瘤2例）,嗅神经母细胞瘤5例,嗅神经鞘瘤1例,鳞状细胞癌2例,血管外皮细胞瘤1例。结论：鼻腔内镜辅助下经额下入路开颅行颅鼻沟通性肿瘤一期手术切除,并进行颅底重建疗效肯定,手术全切率高,并发症发生率低。

Objective： To investigate the diagnosis and micresurgical management of eranionasal tumors. Methods： The clinical characteristics, radiological images and surgical approaches of 17 patients with cranionasal tumors treated between June 2004 and Junary 2006 were analyzed retrospectively. Results： All of the 17 patients were treated through subfrontal approach assisted by transnasal endoscopy. Tumors were resected by one- stage operation, and the anterior skull base was reconstructed. Fourteen cases were totally resected and 3 subtotally resected. CSF rhinorrhea was found in 2 cases, and the occurrence rate was 11.8% （3/17）. Conclusion： Microsurgieal operation via subfrontal approach assisted by transnasal endoscopy was an effective method in the management of cranionasal tumors, with the advantages of high total resection rate with low complication.