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[前颅底肿瘤的多学科手术治疗]

[Interdisciplinary surgical treatment of anterior skull base tumors].

作者信息

Anton J V, Gstöttner W, Matula C

机构信息

Neurochirurgische Universitätsklinik, Wien, Osterreich.

出版信息

Wien Klin Wochenschr. 1999 Jul 30;111(14):560-7.

Abstract

OBJECTIVES

We present our clinical experiences regarding interdisciplinary surgical treatment of anterior skull base tumours and evaluate postoperative results.

METHODS

Fifty-seven patients (25 male, 32 female) with benign and malignant neoplasms involving the anterior skull base were retrospectively reviewed. In all cases tumour resection was carried out by an interdisciplinary rhino-neuro-surgical skull base operating team. Forty-three of 57 patients (75.4%) underwent common transbasal tumour resection and 11 (19.3%) were operated on from an extended transbasal approach. An extensive transbasal approach for tumour resection was used in 3 patients (5.3%). Postoperative mortality and morbidity were evaluated over a period of 6 months.

RESULTS

In all 57 patients a good access to the frontal fossa and the sinuses was achieved. By means of the transbasal approaches, one-step tumour removal was possible in all cases. Tumor diameter ranged fom 12 mm to 114 mm. Even tumours extending as far as the hard palate required no additional transfacial procedures. Surgical mortality was 3.5%. Permanent postoperative complications were noted in 4 cases (7.02%) and transient postoperative complications in 7 (12.28%).

CONCLUSION

In dealing with anterior skull base tumours, interdisciplinary surgical procedures using transbasal approaches provide a satisfactory outcome at a low rate of postoperative complications. When transbasal approaches are applied, no additional transfacial skull base exposure using midfacial incisions is required.

摘要

目的

我们介绍关于前颅底肿瘤多学科手术治疗的临床经验并评估术后结果。

方法

对57例(25例男性,32例女性)涉及前颅底的良性和恶性肿瘤患者进行回顾性研究。所有病例均由多学科鼻-神经外科颅底手术团队进行肿瘤切除。57例患者中有43例(75.4%)接受了常规经颅底肿瘤切除,11例(19.3%)采用扩大经颅底入路手术,3例(5.3%)采用广泛经颅底入路进行肿瘤切除。术后6个月评估死亡率和发病率。

结果

57例患者均能很好地显露额窦和鼻窦。通过经颅底入路,所有病例均能一次性切除肿瘤。肿瘤直径范围为12毫米至114毫米。即使肿瘤延伸至硬腭,也无需额外的经面部手术。手术死亡率为3.5%。4例(7.02%)出现永久性术后并发症,7例(12.28%)出现暂时性术后并发症。

结论

在处理前颅底肿瘤时,采用经颅底入路的多学科手术方法可在较低的术后并发症发生率下取得满意的效果。采用经颅底入路时,无需使用面中部切口额外显露颅底。

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