41例鼻咽血管纤维瘤的诊断和治疗

The diagnosis and treatment of nasopharyngeal angiofibroma

目的 :探讨鼻咽血管纤维瘤的诊断和治疗。方法 :对 4 1例鼻咽血管纤维瘤采用不同进路进行手术治疗 ,其中腭进路 31例 ,面中部掀翻梨状孔进路 7例 ,扩大翼上颌裂进路 3例。结果 :术中平均出血量为 14 5 0ml,选择性瘤体供血动脉栓塞者出血量为 5 0 0～ 80 0ml。术后 1次复发 5例 ,2次复发 3例 ,术后复发时间为 0 .5～2年。结论 :术前应根据CT检查的结果认真制定手术进路 ;术前行血管造影及选择性血管栓塞 ,可明显减少术中出血量。此外 ,根据肿瘤的生长部位 ,在考虑面部美容效果的同时 ,术中应充分暴露术野 。

Objective:To study the diagnosis and treatment of nasopharyngeal angiofibroma.Method:Forty-one cases with nasopharyngeal angiofibroma accepted different kinds of surgical excision:31 cases via palatal approach, 7 cases via mido-facial revelational approach, 3 cases via enlarged pergomaxillary fissure approach.Result:The average of blood loss was 1 450 ml in operation but it became 500～800 ml when had a selective preoperative angiography embolization.After 0.5 to 2 years of operation,five cases recurred one time,three cases recurred two times,one case recurred four times.Conclusion:CT examination is necessary in evaluation of the tumor's size?shape?duration?staging and invasive extent.It is important in designing the operative approach. The preoperative embolization can reduce the amount of bleeding during operation.