颅底内外沟通性肿瘤的手术治疗

前、中颅底内外沟通性肿瘤22例,均经CT和脑血管造影确诊,手术全切除17例,次全切除5例,无手术死亡。随访4个月～3年,显效9例,进步4例,改善4例,恶化2例。作者强调手术应根据肿瘤所侵袭的范围和蔓延方向采用不同的入路,以充分显露,尽可能全切除肿瘤。生物粘合剂和明胶海绵对修补硬脑膜以及重建颅底有效。

Surgery of Tumors Penetrating the SkuII Base

Twenty-two patients with tumors penetrating the anterior and middle skull base are presented. All had intra-and extracranial tumor extension. Of the 22 cases,there.were 5 parients with tumors involving the anterior skull base, cribral sinus and nasal cavity; 9 the sella turcica and sphenoid sinus; 4 the middle skull base, pterygopalatine fossa and orbita; 2 the sphenoid crista and orbita;2 the middle skull base and middle ear cavity. Histological diagnosis; 8 were meningoma (one of them was malignant), 1 chordoma,2 epidermoid carcinoma, 1 adeno carcinoma, 2 neurofibroma. After CT and cerebral angiography,17 cases were total removal, 5 subtatal resection,and none died of operation. The follow-up period ranged from 4 to 36 months,9 cases showed good results,4 marked progress,4 improvement,2 deteriorated, Three patients with malignant tumors died after 6,8 and 11 months of surgery respectively. The authors emphasize the different approach should be used for getting excellent exposure and possible total removal according to the invading limits and extending direction of the tumors,and than the dura mater may be repaired and the skull base may be rebuilt with the bio-adhesive and gelatin sponge.