上颌骨Le Fort I型截骨进路切除巨大鼻咽纤维血管瘤

目的:探讨上颌骨LeFortI型截骨进路切除累及翼腭凹、颞下凹巨大鼻咽纤维血管肿瘤的可行性。方法:采用矫正上颌骨先天或后天畸形的LeFortI型截骨术式进路,切除位于鼻咽部、筛窦等深在部位的纤维血管瘤。结果:该进路术野显露充分,取得了理想的治疗效果。结论:上颌骨LeFortI型截骨进路是切除鼻咽、颅底部纤维血管瘤的理想进路。     

Subselective embolisation in management of JNA

Role of Embolisation in preoperative management of Nasopharyngeal angiofibroma is well established in present day therapeutic modalities. An improvised technique i.e., subselective embolisation has been provided by Interventional radiologists to fortify the therapeutic results. This study compares the final outcome of seven cases, four of which were embolised pre operatively. Each case was dealt with varying surgical approaches.     

术前IADSA和栓塞术在鼻咽纤维血管瘤治疗中的应用

目的：研究分析术前经动脉数字减影血管造影（ＩＡＤＳＡ）和栓塞术在鼻咽纤维血管瘤治疗中的价值。方法：分析本院２１例鼻咽纤维血管瘤患者的临床分析治疗资料，１主后１年复发，再次手术治疗。２２次手术中，术前行及未行ＩＡＤＳＡ和栓塞术的各１１次。 术前示行和行ＩＡＤＳＡ和栓塞术的要中平均出血量和输血量。结果：术前未行和行ＩＡＤＳＡ和栓塞术的术中出量量和输血量分别为１１３６ｍｌ、８３６ｍｌ、６７７ｍｌ、４００     

Evaluation of the effectiveness of preoperative embolization in surgery for nasopharyngeal angiofibroma

We retrospectively analyzed the clinical data of 21 patients (22 procedures) with histologically proven nasopharyngeal angiofibromas. Eleven patients underwent preoperative intra-arterial digital subtraction angiography (IADSA) and embolization with Gelfoam. Embolization reduced the intraoperative blood loss from an average of 1136 ml in the non-embolized patients to 677 ml in the embolized cases (P < 0.05) and transfusions from an average of 836 ml to 400 ml (P < 0.01). Results again show that preoperative embolization is effective in reducing intraoperative blood loss. Received: 10 May 1997 / Accepted: 21 October 1997     

平阳霉素瘤内注射结合动脉栓塞术治疗鼻咽血管纤维瘤

目的探讨平阳霉素瘤内注射结合选择性动脉栓塞术治疗早期及复发性鼻咽血管纤维瘤的疗效。方法对12例鼻咽血管纤维瘤患者数字减影血管造影后行选择性动脉栓塞,栓塞后每12～20天向瘤体内注射平阳霉素12 mg,共4～8次。结果所有病例至少随访1年,治愈及显效者共6例(50%),有效者5例(41.7%),无效1例。结论平阳霉素瘤体内注射结合选择性动脉栓塞是治疗早期及部分复发性鼻咽血管纤维瘤的一种安全有效的非手术治疗方法。     

Distinctive Head and Neck Bone and Soft Tissue Neoplasms

Benign and malignant primary bone and soft tissue lesions of the head and neck are rare. The uncommon nature of these tumors, combined with the complex anatomy of the head and neck, pose diagnostic challenges to pathologists. This article describes the pertinent clinical, radiographic, and pathologic features of selected bone and soft tissue tumors involving the head and neck region, including angiofibroma, glomangiopericytoma, rhabdomyosarcoma, biphenotypic sinonasal sarcoma, chordoma, chondrosarcoma, and osteosarcoma. Emphasis is placed on key diagnostic pitfalls, differential diagnosis, and the importance of correlating clinical and radiographic information, particularly for tumors involving bone.     

Le-fort I access osteotomy to nasopharyngeal tumor – A case-report

Removal of extensive central skull base and paranasal sinus tumors is a significant challenge that is often hampered by limited access and exposure. The safety and efficacy of the Le Fort I osteotomy approach to the skull base have been well established. The purpose of this article is to describe the use of Le fort-1I osteotomy as an access procedure to reach tumors in the nasopharyngeal region in a young patient. The large mass which he presented within the nasopharyngeal region, later diagnosed to be juvenile nasopharyngeal angiofibroma, posed a challenge for surgical access.     

超脉冲CO2激光治疗结节性硬化症患者面部血管纤维瘤疗效观察

目的 探讨超脉冲CO2激光治疗结节性硬化患者面部血管纤维瘤临床疗效、不良反应及复发率.方法 回顾性分析了结节性硬化面部血管纤维瘤患者36例,采用超脉冲CO2激光治疗并根据皮损类型选择治疗参数.结果 36例结节性硬化症面部血管纤维瘤患者与治疗前相比,28例患者单次治疗痊愈10例,显效10例,有效5例,无效3例,复发18例,有效率89.3％,显效率71.4％,复发率64.3％.原发皮损较少且分布较稀疏的患者疗效较好.治疗有效率与年龄、性别、病史的相关性无统计学意义(均P＞0.05).36例患者均无永久性色素沉着、色素减退、萎缩及增生性瘢痕.结论 超脉冲CO2激光治疗结节性硬化患者面部血管纤维瘤有效,不良反应少,但容易复发.原发皮损数量少者疗效好.     

鼻咽血管纤维瘤的微创外科治疗

目的 探讨综合应用多种有效的止血措施,鼻内窥镜下微创外科治疗鼻咽血管纤维瘤的方法.方法 12例患者全部行CT、MRI鼻内窥镜检查术,术前2 d行数字减影血管造影术(DSA),并行供瘤动脉栓塞术,术中控制性低血压,瘤基注射肾上腺素利多卡因液,用自制的微型电刀电切-电凝肿瘤.结果 全部患者均在鼻内窥镜下完全切除肿瘤,无并发症,术后随访1年,无肿瘤复发.结论 选择恰当的手术适应证,术前做好充分的准备,将多种有效的止血措施合理应用并有机结合可减少术中出血.应用微创外科技术治疗鼻咽血管纤维瘤在缩短手术时间、减少手术创伤及并发症的发生、鼻腔功能保存和术后局部复发等方面具有明显的优势.