颅面拆装入路广泛性颅底肿瘤手术(附10例报告)

Surgical treatment of extensive tumors of the skull base by the craniofacial disassembly approach: A report of 10 cases

目的：探讨颅面拆装入路在颅底广泛性肿瘤切除术中的应用。方法：10例范围广泛的颅底区肿瘤分别采用了额鼻拆装，颅面联合入路；上颌窦壁拆装，上颌窦鼻腔入路；颞颧下颌骨拆装，颞面联合入路等3种手术方式切除。结果：2例良性肿瘤术后随访1～3年无复发。8例恶性肿瘤术后，5例已存活3年以上，其中3例已存活5年以上；另3例均在术后3年内死亡或失访，结论：采用颅面拆装入路施行颅底肿瘤切除术，术野暴露较充分，有利于病灶的完全切除，颅底的重要结构可得到保护，并能较好地恢复面部的形态和功能。

Objective:To evaluate the therapeutic effect of craniofacial disassemblyapproach on patients with extensive tumors of the skull base. Methods: Ten patientswith extensive tumors of the skull base were treated in our hospital. Among them,twobenign tumors involving the middle skull base were removed by maxillary sinus wall disassembly approach,eight malignant tumors invading the anterior and lateral skull basewere resected by front-nose and temple-zygoma-mendible disassembly approach. Result:Two benign tumors were followed up respectively for 1 year and 3 years postoperativelywithout evidence of recurrence. Of the eight malignant tumors, 2 cases had survived for 3years,3 cases had survived for 5 years and 3 patients died within 3 years postoperation.Conclusion:It showed that the craniofacial disassembly approach could provide a goodexposure of surgical field to remove the extensive tumors completely and to protect important tissues of the skull base. It was advantageous in facial organ feature and functionrecovery.