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鼻腔和鼻窦肿瘤的颅面切除术。

Craniofacial resection for tumors of the nasal cavity and paranasal sinuses.

作者信息

Hao S P, Chang C N, Hsu Y S, Chuang H L

机构信息

Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, 5 Fu-Hsing Street, Kwei-Shan, Taoyuan, Taiwan.

出版信息

J Formos Med Assoc. 2000 Dec;99(12):914-9.

Abstract

BACKGROUND AND PURPOSE

Craniofacial resection provides multidirectional approaches to remove nasal and paranasal tumors that involve the skull base. The purpose of this study was to determine the survival and local control rate in patients undergoing craniofacial resection for tumors of the nasal cavity, paranasal sinuses, and adjacent areas.

METHODS

The medical records of 30 consecutive patients who had undergone craniofacial resection for tumors of the nasal cavity, paranasal sinuses, and adjacent areas were reviewed. The extent of disease, treatment results, complications, and prognoses were analyzed.

RESULTS

Lesions were malignant in 28 patients and benign in two. Sixteen of the patients had dural or intradural involvement. There was no surgical mortality, and the rate of surgical morbidity was 7%. The 2-year survival of the 28 patients with malignancies was 46% and the mean follow-up time was 35 months. Local control was achieved in 53% of patients. Nine of 16 patients with dural or intradural invasion had a mean survival time of 17 months. There was no significant difference in the frequency of local control between previously treated and untreated patients. Patients who had a clear margin showed significantly better local control than those with an involved or questionable margin.

CONCLUSIONS

Tumors of the nasal cavity and paranasal sinus that involve the skull base can be effectively treated using craniofacial resection, with a reasonable survival and low complication rate.

摘要

背景与目的

颅面切除术为切除累及颅底的鼻腔和鼻窦肿瘤提供了多方向入路。本研究的目的是确定接受颅面切除术治疗鼻腔、鼻窦及相邻区域肿瘤患者的生存率和局部控制率。

方法

回顾了30例连续接受颅面切除术治疗鼻腔、鼻窦及相邻区域肿瘤患者的病历。分析了疾病范围、治疗结果、并发症和预后情况。

结果

28例患者的病变为恶性,2例为良性。16例患者有硬脑膜或硬脑膜内受累。无手术死亡病例,手术发病率为7%。28例恶性肿瘤患者的2年生存率为46%,平均随访时间为35个月。53%的患者实现了局部控制。16例硬脑膜或硬脑膜内侵犯患者中有9例的平均生存时间为17个月。既往接受过治疗和未接受过治疗的患者在局部控制频率上无显著差异。切缘清晰的患者局部控制情况明显优于切缘受累或可疑的患者。

结论

累及颅底的鼻腔和鼻窦肿瘤可通过颅面切除术得到有效治疗,生存率合理且并发症发生率低。

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