摘要
目的总结前颅窝底-鼻腔沟通瘤的一期显微手术切除、颅底重建及手术并发症防治的经验。方法回顾性分析显微手术治疗的23例前颅窝底-鼻腔沟通瘤患者的临床资料。结果肿瘤一期全切除20例,次全切除2例,部分切除1例。2例术后发生皮下感染,经头皮下置管引流+去骨瓣减压术治疗后痊愈。23例患者术后随访10个月至3年,症状均明显改善;2例术后1年复发,再次手术治疗。结论前颅窝底-鼻腔沟通瘤可一期切除并同时修复颅底;颅底的重建应根据不同的情况处理,硬脑膜的不透水缝合是防治术后颅内感染的关键。
Objective To discuss the microsurgical resection of cranionasal tumors and the reconstruction of the skull base by one stage operation and the prevention of postoperative complications. Methods The clinical data of 23 patients with eranionasal tumors undergoing mierosurgery were analyzed retrospectively. All the patients received preoperative MRI and CT examinations to evaluate the destructive extent of the anterior skull base. All the tumors were resected by one-stage operation and the anterior skull bases were reconstructed if necessary. Materials of reconstruction included autogenous periosteum, superficial temporal fascia, fascia lata, temporalis, artificial dura mater, titanium laminae and autogenous skull bone. Results The tumors were totally removed in 20 patients, subtotally in 2 and partially in 1. No patient died. Two patients with post-operative infection were recovered after sub-scalp drainage and bone flap removal. There was no long-term leakage of cerebrospinal fluid in all the patients. The tumors recurred 1 year after the surgery in 2 patients. Conclusion The cranionasal tumors may be totally resected and the anterior skull bases may be reconstructed by one-stage operation. The skull base reconstruction should be individually performed. Waterproof suturation of cerebral dura mater is the most capital procedure to prevent intracranial infection.
出处
《中国临床神经外科杂志》
2014年第8期461-463,共3页
Chinese Journal of Clinical Neurosurgery
