前颅底沟通瘤的外科治疗

Surgical Management of Communicating Tumors in Anterior Skull Base

目的探讨前颅底沟通瘤的诊断、手术方式和疗效。方法对21例前颅底沟通瘤患者进行了手术治疗，并对其疗效进行了随访。结果肿瘤全切17例，大部或部分切除4例。3例出现并发症，其中脑脊液漏1例（5天后自愈），单眼运动障碍加重1例，糖尿病昏迷1例。除糖尿病昏迷患者术后6天死亡外，余20例均痊愈。术后随访3个月～4年，10例资料完整者恢复良好，无肿瘤复发。结论术前依据病人的临床表现、CT或MRI所见评价肿瘤来源，以最短路径、最小脑组织牵拉显露肿瘤主体的思路选择手术入路。术中肿瘤切除后，严密缝合硬脑膜，根据颅底骨缺损范围选择不同方法重建颅底。术后对恶性肿瘤或未能全切肿瘤者辅以放疗，常能获得良好的疗效。

To study the diagnosis, surgical approach and results of communicating tumors in anterior skull base .Methods 21 cases with the tumors undergone the operations were investigated retrospectively . Results The tumorswere totally resected in 17 cases,sub-totally or resected in 4 cases .3 cases had complications after ses had complications ther Opedson and 1them died of diboc care. 10 cases were followed-uP fain 0.25 to 4 yare and no ~r meurrence was found. sions According ti the oboeal features of the agent, the origin of the tumor can be evaluated by CT aam MRI scan.Thegood results could be acquired by selecting an appropriate approach that is ac for ccing a broad acced to the base forremoving the tumors, dulal mater defect and meonstruchng the skull base by means of proper methods.[