鼻中隔黏骨膜瓣修补眼眶和硬腭及前颅底部分缺损

Application of mucoperiosteal flap of nasal septum to repair defect of fossa orbitalis,hard palate and the anterior skull base

目的:探讨利用鼻中隔黏骨膜瓣修补眼眶、硬腭及前颅底部分缺损的效果。方法:对12例鼻腔鼻窦肿瘤患者根据肿瘤性质和病变范围,采用经鼻侧切开上颌骨部分截除或全部截除加筛窦切除术。结果:12例患者中,筛骨水平板破坏5例,筛顶破坏2例,眶顶壁破坏1例,眶内壁及眶下壁破坏各1例,硬腭破坏缺损2例,均在手术切除肿瘤后一期修补成功。无手术死亡、脑脊液漏、颅内感染等其他严重并发症。结论:在鼻腔、鼻窦肿瘤的手术治疗中,当眼眶、硬腭及前颅底骨质受到肿瘤侵蚀,切除肿瘤后形成部分缺损时,可转移适当的鼻中隔黏骨膜瓣一期修补局部缺损。

Objective：To investigate the neoplasty of fossa orbitalis,hard palate and the anterior skull base defect by making use of mucoperiosteal flap of nasal septum.Method：A retrospective study was reviewed in 12 patients with tumors in nasal cavity and nasal sinuses.According to tumor character and range,by partial or total maxillectomy and ethmoidectomy,fossa orbitalis,hard palate and the anterior skull base defects were repaired synchronously on the heels of resection of the tumors which damaged fossa orbitalis,hard palate and the anterior skull base.Result：Among the 12 patients there were 5 patients with the destructions on ethmoidal horizontal plate,2 patients with the destructions on hanging wall of ethmoid,1 patient with the destruction on hanging wall of fossa orbitalis,1 patient with the destruction on medial wall of fossa orbitalis and on floor of orbit respectively,2 patients with the destructions on hard palate and all the destructions were repaired following detection synchronous1y.There were no complications of surgical death,cerebrospinal fluid leaks,encephalomeningocele.Conclusion：During the operation of tumor in nasal cavity and/or nasal sinuses when defect of fossa orbitalis,hard palate and anterior skull base were found and the defects need repair,we can take advantages of mucoperiostea1 flap of nasal septum to perform the transplantation of mucoperiosteal flap in order to avoid forming local defect.