头皮冠状切口在耳鼻喉科前颅底手术中的应用

对鼻腔、鼻窦肿瘤侵及颅底的7例（恶性4例，良性3例）采用头皮冠状切口施行前颅底手术，除1例巨大骨化纤维瘤未予完全切除外，余6例均完全切除病灶。4例恶性肿瘤中2例硬脑膜因肿瘤侵犯予以切除，3例良性肿瘤因硬脑膜变薄致术中撕裂，缺损的硬脑膜及颅底骨板均用帽状腱膜下层一颅骨膜瓣、颞肌筋膜瓣修补，大的颅底缺损用额肌肌皮瓣加固。良性肿瘤3例中，未完全切除的1例随访1年半病情稳定，另2例随访8年和6年无复发。4例恶性肿瘤中，3例分别随访6年、4年、17月无复发，1例术后18个月颅内复发死亡。所有病例未发生术后并发症。文中对该术式的优缺点以及颅底、硬脑膜的切除和修复问题进行了讨论。

Clinical experience of coronal flap approach in surgery of anterior skull base tumor

Surgery of the anterior skull base tumor has been undertaken in 7 cases by coronal flap approach. of which 4 cases were malignant tumors and 3 cases were benign tumors. The dura became torn in 3 cases and resected .in 2 cases due to tumor invasion. The dura and bony defects could be repaired with galea, pericranial flaps and fascia flaps of temporalis. The bigger bony defect was consolidated with scalp flap. Three out of 4 cases with malignant tumors were free of tumors for 6 years, 4 years and 17 months, respectively; 1 case died of tumor recurrence after 18 months. No case had postoperative complications.