嗅神经母细胞瘤的诊断与治疗

目的探讨嗅神经母细胞瘤的临床特点及诊断治疗方法。方法回顾性分析我科1998~2005年手术切除的8例嗅神经母细胞瘤临床资料,结合文献对其临床表现、诊断和治疗进行探讨。结果本组单纯手术1例,手术 放疗6例,手术 放疗及化疗1例。5例行鼻旁-改良翼点入路,2例行扩大额下硬脑膜外入路,1例行额下入路,均于显微镜下行肿瘤切除。1例于2个月内肿瘤复发,病人拒绝再次手术,于1个月后死亡;2例于1年后肿瘤复发,行放疗控制;1例于3年后肿瘤复发,再次手术并联合放、化疗控制;至今仍有3例存活。结论嗅神经母细胞瘤早期诊断困难。经鼻旁-改良翼点入路联合切除是较理想的手术方式。术后联合放疗或化疗十分重要。

Diagnosis and treatment of esthesioneuroblastoma

Objective To discuss the clinical characteristics,diagnosis and treatment of esthesioneuroblastoma(ENB).Methods The clinical data of 8 patients suffering from ENB since 1998 were analyzed retrospectively,and its clinical characteristics,diagnosis and treatment were discussed in combination with review of literatures.Results Of all the 8 cases,one case was treated by surgery alone,six were treated with surgery combined with radiotherapy,and one was treated with surgery combined with radiotherapy and chemotherapy.Five cases were excised via paranasal-improved pterional approach,two via extended subfrontal extradural approach,one via subfrontal approach.All patients were operated through microscope.One case recurred 2 months after surgery,refused reoperation and died 1 month later;two recurred 1 year after surgery and were controlled via radiotherapy;one recurred 3 years after surgery and was controlled via reoperation combined with radiotherapy and chemotherapy.Three cases survied till to the present.Conclusion It is difficult to diagnose ENB early.Paranasal-improved pterional approach is a preferable approach.Postoperative radiotherapy and chemotherapy are very important to the prognosis of ENB.