颅鼻沟通肿瘤切除(附38例报告)

目的 探讨颅鼻沟通肿瘤的显微手术切除与颅底重建的适应症及手术入路选择。方法总结我院收治的38例颅鼻沟通肿瘤，经CT或MRI扫描确诊，手术选择经鼻侧入路或颅鼻联合入路，显微镜下切除肿瘤并行颅底修复重建。结果肿瘤全切除23例，次全切除8例，大部分切除7例，无手术死亡。随访2～5年，30例病人，22例恢复原来的工作，2～3年内肿瘤复发3例，再次手术切除。1～4年内5例恶性肿瘤多处转移、死亡。结论根据肿瘤的大小与累及范围选择鼻侧入路或颅鼻联合入路，显微镜下切除肿瘤或颅底重建是颅鼻沟通肿瘤切除的安全有效方法。

Treatment of cranionasal tumor (a report of 38 cases)

Objective To study the approach to craninasal tumor, the technical of microsurgical operation, and the indication of cranial base reconstruction. Methods Thrity eight cases were dignosised by CT or MRI. Surgical operation was performed through nasal side approach or cranionasal united approach, the tumor was cut off under microscope and basicranial was reconstructed at the same time. Results Total removal of the tumor was in 23 cases, subtotal resection in 8 cases, and part resection in 7. There was no operative mortality. Thirty cases were followed up from 2 to 3 years: 22 patients were recovered. Three had recurred in 2 to 3 years and received a second operation. 5 patients died of maligant tumor metastasis. Conclusion According to the tumor size and involving area, it is a safe and useful way to choose the nasalcauity side approach or cranionasal united approach to remove cranial/nasalcavity tumor and reconstruct the skull loase.