颅面联合进路切除前颅底肿瘤

Combined craniofacial approach for treatment on anterior skull base tumors

目的：探讨累及前颅底或颅内脑组织的鼻腔鼻窦癌的手术切除途径及方法。方法：经颅面联合进路行显微外科连续整块切除累及前颅底或颅内脑组织的鼻腔鼻窦癌15例，其中5例仅累及前颅底，10例累及前颅底至颅内额叶脑组织。硬脑膜缺损应用大腿阔筋膜修补。结果：15例均作了术后随访，随访时间最长为10年，最短2年。其中4例为初治患者，11例为综合治疗后局部复发患者。9例无瘤生存2年以上，2年无瘤生存率为60．00％。11例接受此手术行拯救外科治疗，其中6例无瘤生存2年以上，2年拯救成功率为54．55％。结论：经颅面联合进路行显微外科连续整块切除累及前颅底或颅内脑组织的鼻腔鼻窦癌是可行的。

Objective:To study the craniofacial surgery for the tumors of nasal cavi-ty and paranasal sinuses invading the anteri6r skull base or the intracranial tissue.Method:Fifteen patients were performed with en bloc resection in microurgery for thetumor of nasal cavity and paranasa1 sinuses involving the anterior cranial base or the in-tracranial tissue by combined craniofacial approach. Among them,five cases had the can-cer involving the anterior cranial base and ten cases involving the intracranial tissuethrouh the anterior cranial base. The dural defect resulted from resection were repairedwith femoral fascia. Results:Fifteen cases had been f0llowed up since the operation. A-mong them nine cases with tumor-free had been alive for more than 2 years. The 2-yearsurvival rate with tumor-free was 60. 00%. Eleven patients underwent the operation forsalvaged surgery. Among them, 6 cases with tumour-free had been alive for more than 2years. The 2-year salvaged successuful rate was 54. 55 %. Conclusion: lt is feasible to re-move the tumors of the nasal cavity and paranasal sinuses invading anterior cranial baseor the intracranial tissue in performing en bloc resections by combined craniofacial ap-proach.