经下颌入路切除颅中凹底与颞下窝沟通肿瘤

目的研究经下颌入路切除颅中凹底与颞下窝沟通肿瘤和术后重建的方法。方法采用经下颌入路及与额颞联合入路对11例此区域肿瘤行显微手术切除，手术重建包括硬膜修补、手术残腔消除及骨固定。结果肿瘤全切除11例，次全切除1例，部分切除1例。无死亡及严重残疾。12例临床症状显著改善。2例出现并发症。结论经下颌入路及与额颞联合入路能提供良好的显露．可安全、彻底地切除肿瘤，提高病人生活质量：严格掌握手术指征，使用显微技术，可靠重建颅底，及重视病人术后的功能和美观等，是手术成功的关键。

Resection of the tumors involving both the middle skull base and the infratemporal fossa via transmandibular approach

Object ive To investigate the methods for resection of the tumors involving both the base of the middle cranial fossa and infratemporal fossa via transmandibular approach, and for plastic reconstruction. Methods The transmandibular approach or combined transmandibular and fronto-temporal approach were applied in 13 cases to resect the tumors invading sub-and infra-temporal regions by microsurgical technique. The plastic reconstruction included dural repair, osteosynthesis and obliteration of the operative cavity. Results Tumors were totally resected in 11 patients, subtotally and partially in 1 respectively. No death and severe deformity occurred. Postoperative clinical status was improved dramatically in 12 patients, and complications were found in 2. Conclusion The transmandibular approach or combined transmandibular and fronto-temporal approach can provide excellent visualization and allow for an aggressive and safe resection of neoplasms involving these regions. Serious consideration of operative indications, skillful microsurgical techniques, protection of vital structures, reliable plastic reconstruction, intraoperative monitoring and careful attention to postoperative function and esthetics are very important for successful surgery.