侵犯前颅底的筛窦肿瘤切除

Resection of Ethmoidal Sinus Tumors Invading Anterior Skull Base

目的：探讨侵犯前颅底筛窦肿瘤的手术方式及前颅底重建的方法．方法：对 １９９４～１９９８年间的４例侵犯前颅底的筛窦肿瘤采用额骨硬脑膜外进路颅面联合手术，分别用带蒂额骨膜瓣或帽状腱膜瓣及颅骨内板结合耳脑胶重建前颅底，结果：４例创口一期愈合，均未见脑脊液鼻漏及脑膜脑膨出，１例术后出现一过性尿崩症，１例术后视力提高，术后随访半年至５年，４例均存活．结论：额骨硬脑膜外入路颅面联合手术是切除侵犯前颅底筛窦肿瘤的有效方法，带蒂额骨膜瓣或帽状腱膜瓣与颅骨内板结合重建前颅底可有效地防止脑脊液鼻漏及脑膜脑膨出．

Objective:The surgical method of ethmoidal sinus tumors invading anterior skull base and It's rehibilitation are studied. Methods:4 cases of patients with ethmoidal sinus neoplasms were operated of frontal bone. The anterior skull base was rehibilitated with the flaps of frontal bone and membrane, caplike tendinous membrane, interior plate of skull boneand EC ear-headadhesive respectively. Results: There were no complication of cerebrospinal rhinorrhea and meningo-encephalocele in 4 Cases. The temporary diabetes inspidus took place in one case during 12 days postoperatively. There was enhancement of the eyesight in I Case. All these patients were alive after followed-up for 0.5 - 5 years.Conclusion:the combined intracranial facial resection by the way of frontal bone is the effective therapeutic method of the ethmoidal sinus tumors invading anterior skull base. The flaps of frontal bone membrane, Caplike tendinous membrane, interior plate of skull bone and EC adhesive are better materials for the reparation of anterior skull base.