多学科联合治疗颅鼻沟通性肿瘤

目的:探讨颅鼻沟通性肿瘤的诊断与显微外科治疗。方法:回顾性分析四川大学华西医院神经外科2004年6月~2006年1月手术治疗的17例颅鼻沟通性肿瘤。结果:本组17例病变均经鼻腔内镜辅助下行额下入路,一期手术切除并行颅底重建。手术全切14例,大部切除3例,均恢复良好,2例术后发生脑脊液漏,发生率11.8%。无死亡病例。病理结果:脑膜瘤8例(其中不典型脑膜瘤2例),嗅神经母细胞瘤5例,嗅神经鞘瘤1例,鳞状细胞癌2例,血管外皮细胞瘤1例。结论:鼻腔内镜辅助下经额下入路开颅行颅鼻沟通性肿瘤一期手术切除,并进行颅底重建疗效肯定,手术全切率高,并发症发生率低。

Multi-disciplinary Cooperation in Management of Cranionasal Tumors

Objective:To investigate the diagnosis and microsurgical management of cranionasal tumors.Methods:The clinical characteristics,radiological images and surgical approaches of 17 patients with cranionasal tumors treated between June 2004 and Junary 2006 were analyzed retrospectively.Results:All of the 17 patients were treated through subfrontal approach assisted by transnasal endoscopy.Tumors were resected by one-stage operation,and the anterior skull base was reconstructed.Fourteen cases were totally resected and 3 subtotally resected.CSF rhinorrhea was found in 2 cases,and the occurrence rate was 11.8%(3/17).Conclusion:Microsurgical operation via subfrontal approach assisted by transnasal endoscopy was an effective method in the management of cranionasal tumors,with the advantages of high total resection rate with low complication.