摘要
目的探讨颅底沟通性肿瘤的临床特点、手术入路以及术后重建的方法。方法将颅底划分为不同的区域,按照肿瘤主体累及的部位的不同选用不同的手术入路。采用显微手术,部分辅以内镜切除肿瘤,应用钛板修复颅底骨缺损,近手术区域筋膜、骨膜瓣翻转和背阔肌游离肌皮瓣移植血管吻合修复术后颅底和颅颌面的脑膜缺损和软组织缺损。结果本组43例,肿瘤全切除32 例,近全切除7例,部分切除4例,术后40例临床症状改善,并发症主要为颅神经损伤6例。术后门诊随访30例,随访时间5-20个月,平均9个月,复发3例,无脑脊液漏、颅内感染及其他严重并发症。结论颅底沟通肿瘤的外科治疗较复杂,选用个性化的手术入路,精细的显微操作,配合使用内镜,加之可靠的颅底修复与重建,可以获得较好的临床疗效。
Objective To study surgical approaches and the skills of reconstruction of skull base tumor. Methods Subfrontal approach, frontal-temporal-obitol-zygometic approach, far lateral suboccipital approach and endonasal approach were applied to resect the skull base tumors with microscope and endoscope, galea aponeurotica flaps and revascularized latissimus dorsi muscle flaps were transferred to the skull base for reconstruction.after resecting the tumors Results There are 43 cases with skull bases tumor in our group, 32 of them were totally removed, 7 of them were subtotally removed, 4 of them were partially removed, Clinical features improved in 40 cases, Complications were cranial nerves disorder in 6 cases, 3 recurrent case was encountered in a 5-20 months follow-up in 30 cases. Conclusion Select reasonable surgical approach depending on tumors in different regions, with microsurgical and endoscopy techniques, apply reliable reconstruction can achieve satisfactory results.
出处
《中华神经外科杂志》
CSCD
北大核心
2006年第1期32-35,共4页
Chinese Journal of Neurosurgery
关键词
颅底肿瘤
手术入路
颅底重建
显微外科
内镜
Skull base tumor
Surgical approach
Skull base reconstruction
Microsurgery
Endoscopy
