翼点入路切除前、中颅底沟通瘤

目的　对 7例前、中颅底沟通瘤的手术入路及治疗经验进行总结。方法　颅眶沟通瘤 3例 ,中颅底沟通瘤 4例 ,均采取翼点及其改良入路 ,其中 5例采取硬膜外入路 ,2例结合硬膜内外入路切除肿瘤。结果　 6例患者实现肿瘤全切 ,1例次全切除 ,无手术死亡。结论　翼点入路是切除前、中颅底沟通瘤的理想入路 ,具有显露充分、易于掌握和改良等优点 ;采取带蒂颞肌瓣充填肿瘤切除后的残腔 ,反折骨膜修补硬膜的颅底重建方法可以有效地防止各种并发症的发生。

Treatment of communicating tumor of the anterior and middle cranial fossa by the pteronal approach

Objective To summarize the operative experience of 7 cases with communicating tumor at the anterior and middle cranial fossa. Methods Seven patients, among whom 3 had tumor invading the orbit and 4 had tumor involving the zygomatic fossa, were operated on by the pteronal approach. The extradural approach was used in 5 patients and the extra-intradural approach was used in the other 2 patients. Results Total removal of tumor was achieved in 6 patients and subtotal removeal in the other patient. Conclusion The pteronal approach, which is easy to expose, to master and to alter is ideal in removing communicating tumor at the anterial and middle cranial fossa. The method of reconstructing the skull base by the use of temporal muscles to fill up the cavity after the tumor resection and the rotating periosteum of the frontal bone to repair the dura mater defect is effective to prevent various complications.