经鼻旁——改良翼点入路切除嗅神经母细胞瘤

目的 通过对本组手术方法和入路的探讨,旨在提高嗅神经母细胞瘤的手术疗效。方法 4例嗅神经母细胞瘤患者均先由耳鼻喉科经鼻旁切口入路切除鼻腔及副鼻窦内肿瘤,接着由神经外科医生经改良翼点入路行开颅肿瘤切除及颅底重建。结果 本组4例无手术死亡,其中肿瘤全切除3例,次全切除1例(副鼻窦内残存)。随访3年,3例存活,1例术后死于急性脑梗塞。结论 神经外科、耳鼻喉科联合经鼻旁—改良冀点入路切除嗅神经母细胞瘤是首选治疗手段,术后辅以放疗有预防复发作用。

Excision of Olfactory Neuroblastoma via Paranasal-Improved Pterional Approach

Objective To investigate the surgical approach and operative technigue in management of patient with olfactory neuroblastoma and to improve its therapeutic effect. Methods Four patients with olfactory neuroblastoma were initially pretreated by doctors of ENT to remove the tumor within the nasal cavity or paranasal sinus, then they received the surgical excision of the tumor and reestablishment of skull base by neuosurgeons via a paranasal - improved pterional approach. Result Total tumor removal was accomplished in 3 cases, subtotal in another one. 3 patients remain survived during a 3 - year follow-up period, another patient died of post-surgical brain infarction. Conclusions The authors concluded that it is a preferable way to treat the patient with olfactory neuroblastoma by the cooperation of doctors of ENT and neurosurgeons, and the paranasal - improved pterional approach is the optimun choice during neurosurgery.