Jegoux Fr, Ferron Ch, Malard O, Cariou G, Faure A, Beauvillain De Montreuil C
Service d'ORL et chirurgie cervico-faciale, Hotel-Dieu, place A. Ricordeau, 44093 Nantes Cedex 1, France.
Ann Otolaryngol Chir Cervicofac. 2004 Sep;121(4):213-21. doi: 10.1016/s0003-438x(04)95511-9.
To present results of a retrospective analysis of eighty cases of ethmoid adenocarcinoma. Carcinologic and surgical results of anterior skull base resection via the transfacial approach are presented.
Tumors were classified as 5% T1, 23% T2, 31% T3, 21% T4a and 20% T4b. Thirty-four patients were treated via a paralateronasal approach without skull base resection. Anterior skull bas resections were performed via the transfacial approach for 26 patients and by combined neurosurgical approach for 21.
Mean follow-up was 4.8 years. Survival rate was 63.4% at 5 years and 57.9% at 8 years. Forty-two patients were alive and disease-free at last follow-up. Three patients were alive with recurrence. The rate of local recurrence was 38.8%. Complications occurred in 20% of the patients who had a transfacial approach. Complications appeared to be less frequent than with the combined approach.
Prognosis is related to local control and could be improved by using skull base resection more systematically. In our experience this can be managed by a transfacial approach with similar carcinological results and less complications than the combined approach.
呈现80例筛窦腺癌回顾性分析的结果。展示经面部入路进行前颅底切除术的肿瘤学及手术结果。
肿瘤分类为5%的T1、23%的T2、31%的T3、21%的T4a和20%的T4b。34例患者采用经鼻旁入路且未进行颅底切除治疗。26例患者经面部入路进行前颅底切除术，21例采用神经外科联合入路。
平均随访4.8年。5年生存率为63.4%，8年生存率为57.9%。在最后一次随访时，42例患者存活且无疾病。3例患者存活但有复发。局部复发率为38.8%。经面部入路的患者中有20%发生并发症。并发症似乎比联合入路的情况更少。
预后与局部控制有关，更系统地采用颅底切除术可能改善预后。根据我们的经验，这可以通过经面部入路来实现，其肿瘤学结果与联合入路相似，但并发症更少。
