采用翻揭或拆装扩大术野行颅底深部肿瘤切除术

目的：探讨切除颅底深部肿瘤的手术途径。方法：根据肿瘤位置的不同，分别采用（1）上颌窦前壁拆装；（2）颧弓拆装；（3）鼻锥翻揭；（4）上颌骨翻揭；（5）下颌骨翻揭；（6）唇下面中部翻揭。结果：62例患者术视野充分，肿瘤能完整大块切除，术后头面部畸形不明显，器官功能维护良好。3年生存率为86．1％，5年生存率为66．7％。结论：对颅底深部肿瘤依据不同位置有用翻揭或拆装手术途径，既能使手术野最大暴露，又可将损伤降到最低程度，符合现代颅底外科手术原则。

Resection of the deep tumors of the skull base by the overturn or disassemble approach

Objective:To evaluate the surgical approaches for resection the deep tumors of the skull base.Methods:Based on the sites of the tumors,following approaches were adopted:(1)the anterior maxillary sinus wall disassemble approach;(2)zygomatic arch disassemble approach;(3)nasal pyramid overturn approach;(4)maxilla overturn approach;(5) inferior maxilla overturn approach;(6)midfacial overturn approach.Result:By these approaches,the authors could get good exposure of surgical fields to completely remove the deep tumors of the skull base.The patients result in only little postoperative craniofacial malformation,and good postoperative organ function.Of the 72 cases,62 cases had survived for 3 years(86.1%) and 48 cases for 5 years(66.7%).Conclusion:The overturn or disassemble approach could provide a good exposure of surgical field to remove the deep tumors of the skull base and minimize the surgical trauma,so it accords with the principle of the modern skull base surgery and it is advisable to apply.