CAJ | 학술논문

目的：分析鼻前颅底的解剖学特点，探讨其在鼻内镜下鼻前颅底恶性肿瘤切除术中的应用价值。方法选取2008年9月至2010年9月收治的71例鼻前颅底恶性肿瘤患者，应用鼻内镜微创手术，观察其复发情况及无瘤生存率；并选取20例尸头标本，分为解剖组及鼻内镜组，每组各10例，分别在局部解剖及鼻内镜下观察其解剖学特点，并进行比较。结果71例患者均获得有效随访，随访（35.1±6.2）个月，至随访结束时，共有15例患者出现局部复发，复发率21.1％，无瘤生存34例，无瘤生存率47.9％，带瘤生存22例，带瘤生存率31.0％，病死15例，病死率21.1％。不同尸头中各项观察指标的最大、最小值均存在较大差异。鼻内镜下与局部解剖下观察视神经管形态及走行结果一致。结论不同患者的鼻前颅底解剖结构存在较大差异，因此，在今后的治疗中，应联合鼻内镜技术与影像学检查结果，准确判断不同患者解剖结构的差异，以保证良好的手术效果及安全性。
목적：분석비전로저적해부학특점，탐토기재비내경하비전로저악성종류절제술중적응용개치。방법선취2008년9월지2010년9월수치적71례비전로저악성종류환자，응용비내경미창수술，관찰기복발정황급무류생존솔；병선취20례시두표본，분위해부조급비내경조，매조각10례，분별재국부해부급비내경하관찰기해부학특점，병진행비교。결과71례환자균획득유효수방，수방（35.1±6.2）개월，지수방결속시，공유15례환자출현국부복발，복발솔21.1％，무류생존34례，무류생존솔47.9％，대류생존22례，대류생존솔31.0％，병사15례，병사솔21.1％。불동시두중각항관찰지표적최대、최소치균존재교대차이。비내경하여국부해부하관찰시신경관형태급주행결과일치。결론불동환자적비전로저해부결구존재교대차이，인차，재금후적치료중，응연합비내경기술여영상학검사결과，준학판단불동환자해부결구적차이，이보증량호적수술효과급안전성。
Objective To analyze the anatomical characteristics of nose anterior skull base and to explore the use of endoscopic treatment of nasal skull base malignant tumor. Methods 71 cases of nasal skull base malignant tumor patients in our hospital in 2008 September to 2010 year September were included into this study. All patients were treated with endoscopic minimally invasive operation. The recurrence and disease-free survival rate were observed. 20 cases of cadaveric head specimens were selected. All these cases were divided into anatomical group and na-sal endoscopic group,10 cases in each group,respectively. The anatomical characteristics in local anatomy was observed and compared. Results The maximum,minimum value of different cadaveric heads in the observed indexes were different. The endoscopic and local anatomy observation under the optic canal morphology were performed. 71 patients were followed up for an average follow-up time,about(35. 1 ± 6. 2)months. Up to the end of follow-up,total 15 patients emerged local recurrence. The recurrence rate was 21. 1%. Tumor free survival was observed in 34 ca-ses,tumor free survival rate was 47. 9%. Survival with tumor was observed in 22 cases,the survival rate was 31. 0%. 15 cases died during the follow up,the mortality was 21. 1%. Conclusion There is big anatomy difference in different patients of nasal skull base,therefore,in the future treatment should be combined with endoscopic techniques and imaging findings accurately determine differences in patient anatomy in order to en-sure good surgical results and security.