低温等离子联合彭氏多功能手术解剖器治疗鼻咽纤维血管瘤的临床应用

目的初步探讨低温等离子联合彭氏多功能手术解剖器(PMOD)治疗鼻咽纤维血管瘤的临床疗效。方法回顾性分析广西中医药大学附属瑞康医院耳鼻咽喉头颈外科鼻内镜引导下应用低温等离子联合PMOD对11例鼻咽纤维血管瘤患者行手术治疗的临床资料。结果所有患者均一次完成手术,术中出血量100~1200 ml,平均出血量500 ml,术后病理均确诊为鼻咽纤维血管瘤。术后1例患者出现复视,眼球外展困难,予以激素及对症保守治疗,眼球外展稍改善出院,术后3个月复查复视消失,眼球活动正常。1例术后随访1年时局部复发,予以再次手术治疗并随访1年未见复发,余病例术后随访12~48个月均未见肿瘤复发。结论鼻内镜引导下低温等离子技术联合PMOD可有效的切除鼻咽纤维血管瘤,手术安全性较高,并发症相对较小,是目前治疗鼻咽纤维血管瘤较好的手术方式,值得临床推广及应用。

Pediatric sinonasal and skull base lesions

Pediatric skull base lesions are complex and challenging disorders.Safe and comprehensive management of this diverse group of disorders requires the expertise of an experienced multidisciplinary skull base team.Adult endoscopic skull base surgery has evolved due to technologic and surgical advancements,multidisciplinary team approaches,and continued innovation.Similar principles continue to advance the care delivered to the pediatric population.The approach and management of these lesions varies considerably based on tumor anatomy,pathology,and surgical goals.An understanding of the nuances of skull base reconstruction unique to the pediatric population is critical for successful outcomes.