CAJ | 학술논문

目的总结在神经内镜辅助下前颅底沟通性肿瘤的手术切除与修复方法.方法对19例前颅底沟通性肿瘤采用神经内镜辅助下颅面联合入路进行鼻腔、鼻窦-颅沟通性肿瘤(15例)、鼻-眶-颅沟通性肿瘤(4例)切除术,并同期行带蒂额肌帽状腱膜裂层颅骨瓣修复术.结果 19例患者术后均未发生脑脊液漏和颅内感染,肿瘤全切率78.9%,次全切除率15.8%,部分切除率5.3%.良性肿瘤4例,至今全部存活;恶性肿瘤15例,2年生存11例,3年生存8例,5年以上生存6例.结论神经内镜辅助下颅面联合入路,进行前颅底沟通性肿瘤切除术,加以带蒂额肌帽状腱膜裂层颅骨瓣修复,切除范围安全彻底,修复方便可靠,是一种较为理想的手术切除及修复方法.
목적 총결재신경내경보조하전로저구통성종류적수술절제여수복방법.방법 대19례전로저구통성종류채용신경내경보조하로면연합입로진행비강、비두-로구통성종류(15례)、비-광-로구통성종류(4례)절제술,병동기행대체액기모상건막렬층로골판수복술.결과 19례환자술후균미발생뇌척액루화로내감염,종류전절솔78.9%,차전절제솔15.8%,부분절제솔5.3%.량성종류4례,지금전부존활;악성종류15례,2년생존11례,3년생존8례,5년이상생존6례.결론 신경내경보조하로면연합입로,진행전로저구통성종류절제술,가이대체액기모상건막렬층로골판수복,절제범위안전철저,수복방편가고,시일충교위이상적수술절제급수복방법.
Objective To investigate the clinical effects of communicating tumors on anterior skull base with neuroendoscope-assisted surgery. Methods Nineteen eases of crani-nosel and crani-orbital nosel communicating tumors underwent the combined craniofacial approach. The defect of anterior skull base was repaired with the compound flap with pedicel frontal galea muscle and temporalis myofascial flap.Results All 19 patients were successfully treated without CSF leak and cranial infection. The tumor total re-section rate was 78.9%, subtotal resection rate was 15.8% ,partial resection rate was 5.3%. Four patients of benign tumor were survival,15 patients of malignant tumor 2- year survival was 11, 3-year survival was 8,above 5- year survival was 6. Conclusion The neuroendoscope-assisted combined craniofacial approach can provide a relatively safe and effective resection for communicating tumors on anterior skull base,and has better clinicall value.