Attenborough与改良Barbosa手术进路对翼腭窝肿瘤暴露与术后功能影响的研究

目的：对比Attenborough 与改良Barbosa 手术进路对翼腭窝肿瘤暴露与术后功能的影响。方法：本组选发生翼窝的肿瘤患者15例为研究对象，患者术前行MRI检查确定肿瘤的部位、范围及与周围组织的关系，按MRI显示的病变范围不同选择Attenborough或改良Barbosa 手术进路暴露病变区域并切除肿瘤。术后观察功能影响情况。结果：原发于翼腭窝的肿瘤患者4例，1例采用Attenborough手术进路，3例采用改良Barbosa 手术进路；继发性翼腭窝肿瘤11例，5例源于腮腺深叶的肿瘤均采用Attenborough手术进路，另6例选用改良Barbosa 手术进路。Attenhorough手术6例，术后患侧腮腺颌区明显凹陷，5例口干，2例患者额纹消失，1例患者不唇歪斜。改良Bar-bosa手术9例，6例患侧颊部凹陷，6例患者中5例行赝复治疗；另3例术后无畸形。术后观察3个月-9年6个月，14例无复发，1例术后2年2年月复发。结论：临床应用结果证实Barbosa手术进路应用于翼腭窝肿瘤优于Atten-borough手术进路。

Comparative Research with Attenborough and Modified Barbosa Surgical Approach to Expose Tumors in the Pterygopalatine Fossa and Affect Functions

Objective:This article is to compare research with Attenborough's surgical approach and modified Barbosa approach to expose tumors in the pterygopalatine fossa and affect functions postoperatively.Methods:Fifteen patients with tumor in the pterygopalatine fossa were selected for research.All of the patients underwent preoperative magnetic resonance imaging and/or computed tomography to determine the position and size of the tumor and the relation with around tissues of the tumor.According to shown different size of the tumor by MRI examination, Attenborough or modified Barbosa surgical approach was selected to expose and resect the tumors.After the operation, the conditions affected functions were observed.Results:One patient of four patients with primary tumor in the pterygopalatine fossa used Attenborough surgical approach, other three patients used the modified Barbosa surgical approach; of eleven patients with the secondary tumors extending into the pterygopalatine fossa, five patients with tumor from the deep lobe of the parotid gland used the Attenborough surgical approach, and other six patients used the modified Barbosa approach.Six patients treated by the Attenborough surgical approach had obvious concave deformity on the parotid gland and the retromandibular region involved side, five patients of them had the dry month,two patients had disappearance of the forehead stripe, one patient had inclination involved the corner of the mouth.Nine patients were operated on by modified Barbosa surgical approach, six patients of them had the concave deformity of the buccofacial region, five patients of six patients were repaired with a prosthesis, another three patients had no deformities on the operative side.All the patients were followed up from 3 months to 9 years and 6 months postoperatively, fourteen patients had no recurrence, one patient had recurrence in 2 years and 2 months after operation.Conclusions:The experience used in clinical practice has indicated that modified Barbosa surgical approach has the advantage of Attenborough surgical approach for the tumors in the pterygopalatine fossa.