鼻咽纤维血管瘤手术径路探讨——附56例报告

A study of approach of operation on patients with juvenile nasopharyngeal angiofibroma -Report of 56 cases

目的 :探讨鼻咽纤维血管瘤手术径路适应证及优缺点 ,提高治疗水平。方法 :回顾分析住院治疗的 5 6例鼻咽纤维血管瘤病例 ,经腭部径路 4 5例 ,经鼻腔径路 7例 ,经口腔口咽径路 2例 ,颅内外联合径路 2例。结果 :除 1例因肿瘤侵犯广 ,侵入右颞叶脑组织 ,术中出血多 ,放弃手术 ,仅探查并活检外 ,其余 5 5例均顺利完成手术。结论 :手术径路的选择以肿瘤的部位、大小、侵犯的范围为标准 ,充分暴露瘤体为原则 ,对于侵犯至颅内的病例 。

Objective: To explore the approach of operation on patients with juvenile nasopharyngeal angiofibroma. Method: Fifty six patients with juvenile nasopharyngeal angiofibroma were treated by surgery in our department from January 1982 to December 2001. There were 56 males, ranging in age from 9 to 43 years old. The clinical data of 56 cases were retrospectively analyzed. Four ways of operative approach were applicated according to pattern of tumor for this surgery: through the palate (45 cases); through the nasal cavity (7 cases); through the oral\|pharynx (2 cases) and through the combined otolaryngeal\|neurosurgery approach (2 cases) to remove tumors. Result: Fifty\|five patients were cured, one case failed because of tumor invade in brain. Conclusion: According to the tumor site, size, shape and invasive extent, the operative approach would be selected which was important for the cure effect. The transpalatal approach is most widely used.