前、中颅底、咽及咽旁间隙肿瘤手术治疗方法的探讨

目的：探讨彻底切除前、中颅底、咽、咽旁间隙肿瘤的理想手术入路。方法：采用上颌外旋入路切除累及多区的前、中颅底肿瘤16例；采用下颌外旋入路切除鼻咽、口咽及颅底肿瘤26例。结果：16例上颌外旋术后随访2—5年，生存4年以上者3例、3年以上者6例、2年以上者6例，术后1个半月死亡1例。26例下颌外旋随访8个月-6年，4例良性肿瘤无复发，存活5年以上4例、4年以上6例、3年以上3例、2年以上3例、1年以上1例。现大部分病例仍在随访中。结论：上颌外旋及下颌外旋入路是彻底切除前、中颅底、咽、咽旁间隙肿瘤的的理想、可靠的手术入路。

Study of resection of tumors in the anterior and middle skull base, pharynx and parapharyngeal space

Objective:To seek for a better approach for the resection of tumors in the anterior and middle skull base,pharynx and parapharyngeal space.Methods:16neoplasmas involving the ante-rior and middle skull base were removed through the maxillary swing and26tumors in the pharyn-geal,parapharyngeal space and skull base were resected via mandibullar swing approach.Results:The16cases treated through maxillary swing were followed up for2to5years:3survived for more than4years,6for3years,6for2years,1died in1month.The26cases treated via mandibular swing were followed up for18months to6years.4cases with benign tumors were living well and tu-mor free.In the malignant group,2died in6months,2died in1year,one died of lung metastasis in2years,4survived for more than5years,6for4years,3for3years,3for2years and1for1year.Conclusion:It can be concluded from the outcome that these procedures provide good exposure to the anterior and middle skull base,pharynx and parapharyngeal space for safe and thorough resec-tion of tumors with minimal morbidity.