颅面联合切除侵及颞下凹和中颅底的颌面部肿瘤

Combined craniofacial resection of maxillofacial tumors involving infratemporal fossa and lateral skull base

目的：探讨手术治疗侵入颞下凹或中颅底的颌面部肿瘤的相关问题。方法：报告５例采用颅面联合切除方法治疗腮腺肿瘤、颧骨巨细胞瘤和三叉神经恶性神经鞘瘤。结果：５例患者手术全部成功。结论：先颅外后颅内的手术方式能减少手术危险性，中颅底处理中不可进入茎突、翼钩连线以内，首选旋转颞肌瓣修复颅底缺损并填塞颞下凹死腔。

Objective: To study the methodology of the surgical treatment of maxillofacial tumors which involve infratemporal fossa and the base of medius skull. Methods: Five cases of parotid gland tumor, zygomatic giant cell tumor and malignant neurilemmoma were treated with combined craniofacial resection. Result: All the operations were successful. Conclusion: The operative approach from maxillofacial part to skull base might decrease the mortality of operation. The region inside a line from the styloid process to the hamulus of the pterygoid process should not be involved in the osteotomy of skull base. The gyrate temporal muscular flap can be used to repair the defects of skull base and to fill the cavity of infratemporal fossa.