鼻内镜下切除鼻颅底软骨肉瘤

目的 探讨鼻颅底软骨肉瘤的临床特点及鼻内镜下切除该肿瘤的方法.方法 2001-2008年对7例鼻颅底软骨肉瘤患者采用以鼻内镜下肿瘤切除术为主的方式治疗,其中男4例,女3例;年龄18～47岁,中位年龄31岁.临床症状包括:鼻塞、鼻出血、流涕、头痛、复视、眼球外展障碍、视物模糊乃至失明.手术方法是先找出肿瘤与正常组织附着部,根据肿瘤边界较为清晰、肿瘤与正常软组织或骨质存在质地差异等特点,用剥离的方法,将肿瘤切除.肉眼残留肿瘤以电钻等方式予以清理.结果 7例患者均采用鼻内镜下手术治疗,术后随访24～108个月,中位随访时间36个月,5例无复发,2例带瘤存活.结论 鼻内镜下手术切除颅底软骨肉瘤可取得较好的临床效果.

Nasal endoscopic surgical treatment for chondrosarcoma of paranasal sinus and the skull base

Objective To discuss the clinical characteristics and treatments for chondrosarcoma of paranasal sinus and the skull base. Methods The clinical characteristics of chondrosarcoma of paranasal sinus and skull base in 7 patients tmderwent endoscopic surgeries between 2001 and 2008 were analyzed. Of the patients,4 men and 3 women. The patients' age ranged from 18 to 47 years,with a median of 31 years. Clinical symptoms: stuffy, nose bleeding, runny, headache, diplopia, eye outreach limited, blurred vision and even blindness. Surgery methods:under nasal endoscopy,after the attachment sites of the tumors to normal tissues were confirmed,the tumors were peeled off along the clear boundary between the tumors and normal tissues,and the potential residual tumor tissues on bones were cleared by a drill. Results The patients were followed up postoperatively for 24 to 108 months,with a median of 36 months. Five of 7 patients were no recurrence,2 were alive with tumor. Conclusions Chondrosarcoma of paranasal sinus and skull base can be treated by nasal endoscopic surgery, with good clinical outcome.