摘要
目的探讨经颅眶入路切除巨大额窦骨瘤的手术方法及疗效。方法回顾性分析17例巨大额窦骨瘤患者的临床资料及经颅眶入路手术方法。男9例,女8例;年龄15～55岁,平均35.2岁;肿瘤最大径2.8～6.2mm,平均3.9mm。所有患者均经颅眶入路,其中12例患者应用冠状切口,5例患者采用眉弓切口。结果17例肿瘤均获得全切除,其中5例完整摘除。术后4例上睑下垂,均于2～3个月恢复。无脑脊液漏、颅内感染等并发症。术后14例(82%)随访6个月至8年,平均34个月,无骨瘤复发或鼻窦阻塞性黏液囊肿发生。结论巨大额窦骨瘤适合经颅眶入路手术,手术安全有效。额窦的处理是手术的关键,肿瘤切除后评估额窦情况,采取闭塞窦腔或额窦开放引流术,联合鼻内镜手术有利于保证额窦引流通畅。
Objective To explore transcranio-orbital approaches and surgical outcomes for large frontal sinus osteomas.Methods Seventeen cases who underwent transcranio-orbital approach from Oct.2001 to Feb.2009 were retrospectively analyzed with clinical manifestations,neuroradiological festures and operative techniques.Patients ages：15 to 55 yrs,35.2 yrs in average;sex：9 male,8 female.The maximum diameter of tumors ranged from 2.8 to 6.2cm（mean,3.9cm）.Bicoronal incisions were used in 12 cases,supraorbital eyebrow incisions in 5 cases.Results Complete tumor removal was achieved in all cases（5 cases were removed en bloc）.Postoperatively,ptosis was found in 4 cases and all recovered within 3 months.There was no CSF leakage or intracranial infection.Duration of follow up was 6 months to 8 years,there was no recurrence of osteomas or mucoceles formation.Conclusions Transcranio-orbital approach is suitable for the treatment of large frontal sinus osteoma,this approach is relatively safe and complications can be minimized.Management of frontal sinus is the key of the approach,two techniques were used：obliterated or opened and drained.Together with nasal endoscopic management helps to the preservation of the natural drainage of the frontal sinus.
出处
《北京医学》
CAS
2010年第5期341-344,共4页
Beijing Medical Journal
关键词
骨瘤
额窦
内镜
神经外科手术
Osteoma Frontal sinus Endoscopy Neurosurgical
