累及颅底的骨纤维异常增生症的治疗

The treatment of fibrous dysplasia involving skull base

目的:探讨累及颅底的骨纤维异常增生症的诊断与治疗方法。方法:回顾性分析15例骨纤维异常增生症患者的临床资料。结果:所有患者均行CT影像学检查,显示病变累及眶板15例,筛骨15例,中、下鼻甲8例,额骨8例,蝶骨6例,其中视神经管受累4例,但视力下降者仅有1例。均采用颅面联合入路手术,其中1例行视神经管减压术。用钛板重建颅底骨质缺损。术前视力下降者视力好转,无颅内感染等严重并发症发生。结论:有明显症状的累及颅底的骨纤维异常增生症可行保守性手术治疗,是否行预防性视神经管减压术应根据临床和影像学具体情况来确定。

Objective：To investigate the diagnosis and treatment of fibrous dysplasia （FD） involving the skull base. Method：The clinical data of 15 patients with fibrous dysplasia involving the skull base was retrospective analysis. Result：All patients were underwent CT examinations. FD involved orbital roof in 15 patients, ethmoidal bone in 15 patients, middle and lower nasal turbinate in 8 patients, frontal bone in 8 patients, sphenoidal bone in 6 pa tients, and maxillary bone in a patient. Although the optic canal was affected in 4 patients, only one patient had impaired vision. All the patients were treated by craniofacial approach. One patient with impaired vision was performed decompression of optic canal and had improved in vision. The titanium mesh was use for construction of skull base defect. There were not complications, such as infection, cerebral hemorrhage, etc. Conclusion： It should be underwent surgical treatment for fibrous dysplasia involving skull base which resulted in clinical manifestations. Whether prophylactic decompression of optic canal is performed or notr depends on the patients clinical and radio logical information.