颅底恶性肿瘤切除术后组织缺损一期修复的探讨──附18例报告

目的：为解决颅底恶性肿瘤的广泛切除或根治性切除术后所致的颅底骨与软组织缺损，预防此缺损所致的颅内感染，脑脊液漏等并发症。方法：在术中应用了斜方肌下部岛状肌皮瓣，胸大肌下部岛状肌皮瓣，颞肌复合组织瓣等各种修复方法分别对18例患者进行了一期修复。结果：修复成功率73．2％（13例），术后并发症27．8％（5例）.结论：根据组织缺损的不同大小、范围、程度、部位和不同的手术入路来选择不同的修复方法，关系到手术成败。

STUDY ON FIRST STAGE RECONSTRUCTION OF TISSUE DEFECT AFTER SKULL BASE MALIGNANT TUMOR RESECTION

Objective: To develop first stage reconstruction for tissue defect on the skull base. Metheds: 18 patients with malignant tumor had defect on the skull base. The defect and the soft tissue were reconstructed through the island musculocutaneous flap of the lower trapezius, the temporalis muscle compound flap, and the pectoralis major myocutaneous and temporalis musculoosseous flap. Results:The cure rate is 73. 2% (13 cases). 5 cases suffered from postoperative complications (27. 8% ). In 3 cases local death of the musculocutaneous flap occurred. 1case of CSF leak and 1 case infection recovered after treatment. Conclusion: It is important to adopt different metheds of reconstruction for defect different in size,degree, location and operative approaches.