颅面联合手术切除前颅底沟通肿瘤的临床疗效分析

Clinical analyze of effects on combined anterior craniofacial resection for extracranial-intracranial tumors of anterior skull bases

目的研究颅面联合手术切除前颅底沟通肿瘤的疗效,为改进手术操作提供依据。方法回顾性分析16例采用颅面联合手术切除并颅底重建的前颅底沟通肿瘤患者的临床资料,对术后早期相关并发症、相关影像学表现、病理结果、术中情况等进行分析总结。结果本组16例患者中肿瘤全切除9例,次全切除4例,部分切除3例。有5例患者术后出现一种或数种相关并发症,其中术后短期颅内积气4例、脑脊液漏3例、短暂性精神异常2例、颅内感染2例、切口感染2例、复视1例、尿崩症1例。以上所有术后并发症,予以对症处理后均有好转。患者的手术远期效果好,无严重术后并发症或后遗症发生。结论颅面联合手术入路方案是颅底区沟通性肿瘤外科治疗的良好手术方式,该术式可有效降低患者术后相关并发症的发生率,改善预后。

Objective To investigate the effects of combined anterior craniofacial resection for extracranial-intracranial tumors of anterior skull bases,and give support to improve surgery skills.Methods The clinical data of 16 communicative tumors of anterior skull bases patients with combined craniofacial surgery to excision and reconstruction of skull base were retrospectively analyzed.The early postoperative complications,imaging finding,pathological examination,etc.were analyzed.Results Of 16 patients,9 had total resection,4 subtotal resection and 3 partial resection.The were 5 patients got at least one or more complications including 4 short-term intracranial pneumatosis,3 CSF leak,2 brief mental symptoms,2 intracranial infection,2 incision infection,1diplopia and 1 diabetes insipidus.All patients recovered after symptomatic treatment.The surgical results were satisfied and no serious postoperative complications happened.Conclusion Combined anterior craniofacial resection is a good way to the tumors communicating the anterior skull base,it can effectively reduce the incidence of postoperative complications related to the patients and improve the prognosis.