摘要
目的分析鼻前颅底的解剖学特点,探讨其在鼻内镜下鼻前颅底恶性肿瘤切除术中的应用价值。方法选取2008年9月至2010年9月收治的71例鼻前颅底恶性肿瘤患者,应用鼻内镜微创手术,观察其复发情况及无瘤生存率;并选取20例尸头标本,分为解剖组及鼻内镜组,每组各10例,分别在局部解剖及鼻内镜下观察其解剖学特点,并进行比较。结果 71例患者均获得有效随访,随访(35.1±6.2)个月,至随访结束时,共有15例患者出现局部复发,复发率21.1%,无瘤生存34例,无瘤生存率47.9%,带瘤生存22例,带瘤生存率31.0%,病死15例,病死率21.1%。不同尸头中各项观察指标的最大、最小值均存在较大差异。鼻内镜下与局部解剖下观察视神经管形态及走行结果一致。结论不同患者的鼻前颅底解剖结构存在较大差异,因此,在今后的治疗中,应联合鼻内镜技术与影像学检查结果,准确判断不同患者解剖结构的差异,以保证良好的手术效果及安全性。
Objective To analyze the anatomical characteristics of nose anterior skull base and to explore the use of endoscopic treatment of nasal skull base malignant tumor. Methods 71 cases of nasal skull base malignant tumor patients in our hospital in 2008 September to 2010 year September were included into this study. All patients were treated with endoscopic minimally invasive operation. The recurrence and disease-free survival rate were observed. 20 cases of cadaveric head specimens were selected. All these cases were divided into anatomical group and na-sal endoscopic group,10 cases in each group,respectively. The anatomical characteristics in local anatomy was observed and compared. Results The maximum,minimum value of different cadaveric heads in the observed indexes were different. The endoscopic and local anatomy observation under the optic canal morphology were performed. 71 patients were followed up for an average follow-up time,about（35. 1 ± 6. 2）months. Up to the end of follow-up,total 15 patients emerged local recurrence. The recurrence rate was 21. 1%. Tumor free survival was observed in 34 ca-ses,tumor free survival rate was 47. 9%. Survival with tumor was observed in 22 cases,the survival rate was 31. 0%. 15 cases died during the follow up,the mortality was 21. 1%. Conclusion There is big anatomy difference in different patients of nasal skull base,therefore,in the future treatment should be combined with endoscopic techniques and imaging findings accurately determine differences in patient anatomy in order to en-sure good surgical results and security.
出处
《临床和实验医学杂志》
2014年第10期799-801,共3页
Journal of Clinical and Experimental Medicine
基金
上海建工集团资助项目
项目编号:11ZGZS-03
关键词
恶性肿瘤
鼻前颅底
解剖
鼻内镜
Malignant tumor
Nose anterior skull base
Anatomy
Nasal endoscope
