鼻内镜下Le Fort I截骨进路治疗鼻咽血管纤维瘤

Clinical effect of Le Fort I osteotomy approach associated with endoscope for the resection of juvenile nasopharyngeal angiofibroma

目的探讨鼻内镜辅助下LeFortI截骨进路治疗鼻咽血管纤维瘤的临床效果。方法回顾性分析2004年2月至2009年8月中国医科大学附属第一医院应用鼻内镜外科技术和LeFortI型截骨进路治疗鼻咽血管纤维瘤Radkowski Ⅱb期的3例住院患者，术后1、3、6个月及1年定期门诊复查，术后2年以上鼻内镜检查、鼻窦cT检查及随访评估临床效果。结果3例患者肿瘤完全切除，无并发症，术后均随访2年以上无复发，无面容改变，牙齿咬合良好，能进食硬食，1例稍有牙体麻木感。结论对瘤体广泛侵及翼腭窝、颞下窝的鼻咽血管纤维瘤采用鼻内镜辅助下Le Fort I截骨进路，术野暴露充分，能彻底切除肿瘤，面部不留切痕，效果良好。

Objective To analyze the clinical effect of Le Fort I osteotomy approach associated with endoscope for the resection of juvenile nasopharyngeal angiofibroma. Methods Three patients with juvenile nasopharyngeal angiofibroma, stage II b, were retrospectively analyzed. All of them underwentLe Fort I osteotomy approaeh associated with endoscope between 2004 and 2009. All patients were followed up at first, third, sixth months and one year after surgery. Two years later, endoseopie examination and CT scan were performed, to analyze the clinical effect. Result All three patients had total removal of tumor and no postoperative complications. No tumor recurrence was found 2 years after operation, and no face deformity. The tooth articulation was recovered, these patients could eat hard diet, although one patient had lose a little teeth sensation. Conclusion Le Fort I osteotomy had good clinical effeet, if assoeiated with endoseope ,it could get a good surgical exposure, and can do well in the treatment on juvenile nasopharyngeal angiofibroma, even intruded into pterygopalatine and infratemporal fossa.