扩大额下硬膜外入路显微镜下切除颅底脊索瘤18例报告

A retrospective analysis of removal of 18 cases of chordoma in skull base via the extended subfrontal epidual approach.

目的探讨扩大额下硬膜外人路显微镜下切除颅底脊索瘤的手术方法。方法回顾总结经扩大额下硬膜外入路显微镜下切除颅底脊索瘤18例的手术经验。结果肿瘤全切除15例（83％），次全切除3例（17％），术后无发生任何并发症。结论扩大额下硬膜外入路显微下切除颅底脊索瘤，具有术野开阔、视野清晰、操作方便和减少牵拉等优点。腰椎置管脑脊液持续引流降低颅内压和颅底重建术，对于提高肿瘤全切除率和减少并发症有重要意义。

Objective To study the surgical techniques of the extended subfrontal epidual approach to resect chordoma in skull base. Methods 18 cases of chordoma in skull base treated microsurgically were analyzed retrospectively. Results Total resection were achieved in 15 patients（ 83% ） , gross resection in 3 patients （17%）. There was no complication in all cases. Conclusion The microsurgery for ehordoma in skull base via the extended subfrontal epidual approach is of the benefits such as clear and wide fields of vision, and minimize brain trauma. Lumber drain placement and the skull base reconstruction could improve the rate of total tumor re- moval and reduce complications.