经颅面联合入路显微手术切除累及脑额叶的鼻腔鼻窦癌

Combined craniofacial approach for microsurgical treatment of the tumor of the nasal cavity and paranasal sinuses invading the frontal lobe

目的 探讨累及额叶的鼻腔鼻窦癌的显微手术切除途径及方法。 方法 回顾分析经颅面联合进路行显微外科整块切除累及额叶的鼻腔鼻窦癌 13例的临床资料。硬脑膜缺损应用大腿阔筋膜修补。 结果 11例经综合治疗后局部复发病例接受此手术 ,其中 3例局部再次复发。 2例为首次治疗病例。2年无瘤生存率为 72 .73%。 结论 经颅面联合进路行显微外科整块切除累及额叶的鼻腔鼻窦癌具有临床实用性 ,具有暴露清楚、能在直视下整块切除肿瘤和受累的脑组织 ,并妥善修复硬脑膜等优点。

Objective To investigate the approach and resection techniques for the tumors of nasal cavity and paranasal sinuses invading to the frontal lobe Method We retrospectively reviewed the medical material of 13 patients with advanced malignant tumors of nasal cavity and paranasal sinuses involving the frontal lobe who underwent combined craniofacial resection with en bloc microsurgical resection The dural defects resulted from resection were repaired with femoral fascia Results Of recurrent tumors in 11 patients Tumors still recurred in 3 patients althrough salvaged surgery have been taken 2 patients underwent primary surgery The 2 year survival rate with tumor free was 72 73% Conclusion It is feasible to remove the tumor of the nasal cavity and paranasal sinuses invading the brain tissue of the frontal lobe through combined craniofacial approach The approach offers the advantages of clear exposeure en bloc resection under vision and dural repair.