颅内外沟通性肿瘤的外科治疗

目的 探讨颅内外沟通性肿瘤的外科治疗。方法 统计分析我院自2001年1月至2005年5月治疗的32例颅内外沟通性肿瘤，其中恶性肿瘤22例，良性肿瘤10例，20例进行颅面联合进路肿瘤切除；10例在鼻内镜辅助下开颅手术切除；2例行颅外进路肿瘤切除，对颅底缺损的修复用帽状腱膜-颅骨骨膜瓣、颞肌-肌筋瓣、颅骨骨瓣、前臂皮瓣等。结果 22例恶性肿瘤中随访2年以上6例，1～2年8例，1年以下7例，1例死亡，1例脑转移带瘤生存，其余均健在。10例良性肿瘤无复发。结论 对颅内外沟通性肿瘤，应根据肿瘤的位置、大小及颅内累及的情况，选择合适的手术人路，在保证肿瘤切除彻底的前提下，尽可能的减小损伤，对部分颅内外沟通性肿瘤，鼻内镜辅助下手术，可减小创伤，同时面部无疤痕。

Surgical management of the skull base tumor

OBJECTIVE To investigate the surgical management of the skull base tumor. METHODS Thirty two cases of skull base tumor were surgically management in our hospital from Jan. 2001 to May 2005. There were 22 cases with malignant neoplasm and 10 cases with benign tumor. Combined cranialfacial approach procedure had been done in 20 patients, and video-aided cranial surgery in 10 patients, maxillary or mandible swing approach in 2 patients. The skull membrane, temporal muscle flap, skull bone flap and free forearm flap were used to repair the defects of the cranial base. RESULTS For the 22 cases of malignant neoplasm, 6 cases were followed up for over 2 years, 8 cases over 1 year. One case died of the disease and 1 case alive with brain metastasis. There were no recurrence in the 10 cases with benign tumor. CONCLUSION Through the surgical management, the good results could be obtained for the skull base tumor.