内镜经鼻颅内外联合入路切除前中颅底沟通瘤

目的 探讨内镜绛鼻颅内外联合入路切除前中颅底沟通瘤的手术方法.方法 对13例患者在扩大经额下入路显微切除肿瘤颅腔内部分的基础上,采用经鼻内镜下切除肿瘤颅外部分并重建颅底缺损.结果 手术全切除11例,次全切除2例,无手术死亡和新神经功能废损、脑脊液漏、脑膜腩膨出及颅内感染等并发症发生.术后病理爪神经鞘瘤4例,鼻咽纤维血管瘤3例,脑膜瘤2例,垂体瘤、内翻性乳头状瘤、鳞状细胞痛和嗅神经母细胞瘤符1例.结论 采用内镜经鼻颅内外联合入路切除前中颅底沟通瘤创伤小且深部视野良好,能安全且完全切除良性肿瘤.

Endoscopic transnasal combined transcranial resection of anterior-middle skull base communicative tumors

Objective To explore endoscopic transnasal combined transeranial resection of anterior-middle skull base communicative tumors. Method 13 patients with fronto-naso-orbital tumors were treated combined with extend subfrontal approach and endoscopic transnasal approach and skull base reconstruction. Results Tumors were totally removed in 11 cases and subtotally in 2 cases which were malignant tumors. In all cases, there were 4 neurinoma,3 nasopharyngeal fibroangioma,2 meningeoma, 1 hypophysoma, 1 inverted papilloma, 1 squamous cell carcinoma and 1 enthesioneuroblastoma. No serious operative complications,such as death,intracranial infection, CSF leakage or impulse exophthalmos were happened. Conclusions Endoscopic transnasal combined transcranial approach can remove anterior-middle skull base communicative tumors safely and completely in appropriate cases.