颅底肿瘤手术的入路与疗效观察

目的:探讨颅底肿瘤手术入路与治疗效果之间的关系。方法:回顾性分析18例颅底肿瘤患者采用不同入路的临床资料。其中良性肿瘤10例,恶性肿瘤8例。前中颅底肿瘤13例,侧颅底肿瘤5例。结果:18例患者经1～5年随访,良性肿瘤10例中9例无复发,1例带瘤生存。恶性肿瘤8例中,2例鼻咽癌分别随访1年1个月和2年,生存良好。余6例分别随访3年和5年,3、5年生存率分别为50％(3/6),33.3％(1/3)。死亡原因是局部复发、肺部转移,颅内侵犯。结论:根据颅底肿瘤的大小、位置及性质选择最佳的手术入路,既能充分暴露和切除肿瘤,又能保护重要的解剖结构,减少或防止术后并发症。

Surgical Approaches and Results in Operative Treatment of Skull Base Tumors

Objective: To investigate the relationship between operative approach and result in operative treatment of skull base tumors. Method: A review of 18 skull base tumors resection carried out by way of unlike operative approach was presented. Of the 18 cases, 10 cases were affected with benign tumors , and 8 with malignant tumors. 13 cases were involved in anterior and middle cranial fossa, and 5 cases in the lateral cranial base. Results: All patients were followed up from 1 to 5 years. In the benign tumors group, 9 cases achieved good results and 1 case lived with the tumor. Of the 8 cases with malignant tumors, 2 cases of carcinoma of nasopharynx were followed up 13 months and 2 years respectively. The survival rate at 3 and 5 years of the remaining 6 cases were 50%(3/6) and 33.3%(l/3) . 5 cases died from local recurrence , lung metastasis or intracranial invasion. Conclusion: According to the site, range and pathology of the skull base tumors, the best operative approach should be selected. The operative approach selected should be safe for operation and can obtain a better exposure of the tumor and fully remove it, so that the critical anatomic structures can be protected and the postoperative complications can be reduced and prevented, too.