经口咽入路切除巨大斜坡肿瘤一例报告

Case report: giant clival tumor resection via transoral approach

目的:探讨斜坡肿瘤的临床特点和手术治疗,以提高治疗效果。方法:对甘肃省人民医院神经外科经口咽入路切除巨大斜坡肿瘤1例病例的临床及手术资料进行回顾性分析。结果:本例患者主因吞咽困难、声音嘶哑2年,加重伴左颈肩部疼痛2个月入院,影像学检查提示中下斜坡巨大占位性病变,向后压迫桥脑和延髓,向前推挤咽后壁软组织,鼻咽腔变窄,颅底斜坡、左侧颞骨和寰椎左侧骨质破坏。在耳鼻喉科、口腔颌面外科医生的协助下为患者施行了经口咽入路斜坡肿瘤切除术。术后患者临床症状明显缓解。病理检查提示为脊索瘤。结论:手术入路的选择、多学科协作、熟练的手术技巧是手术成功的重要因素。

Objective： To explore the clinical characteristics and surgical treatment of clival tumor, so as to improve the outcome. Methods： A case of clival tumor resection through transoral approach in the department of neurosurgery, Gansu Provincial People＇s Hospital was retrospectively analyzed. Results： ＂Ihe patient was admitted for dysphagia, hoarseness for 2 years and the aggravation of the diseases accompanied the pain of the left neck and shoulder for 2 months. Imaging examinations showed a giant mass lesion in the middle and lower clivus, the pons and medulla were notably extruded and the nasopharyngeal cavity was narrowed, the divus, the left temporal bone and the left side of the atlas were destroyed. The tumor was resected via transoral approach with the assistance of otolaryngologist and maxillofacial surgeons. The clinical symptoms of the patient were significantly relieved. Pathological examinations revealed chordoma. Conclusion： The choice of surgical approach, multidisciplinary team and skillful surgical technique are the decisive factors of the success.