Wang Tianduo, Wang Xiaobin, Li Mei, Xu Anting, Chen Ying
Department of Otolaryngology, Qilu Hospital of Shandong University, Jinan, 250012, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2007 Jan;21(2):50-1.
Study for surgical approaches on anterior skull base tumors.
All 37 cases with anterior skull base tumors were surgically treated. Twenty-one cases were treated with anterior craniofacial approaches: Frontal subcranial combined with total maxillectomy in 8 cases or/with orbital exenteration in 5 cases, combined with lateral rhinotomy in 1 cases, combined with naso translocation with medial maxillectomy in 7 cases. Partial or total maxillary swing combined with naso pyramid translocation in 13 cases. Frontonasal, fronto-orbital and midface degloving in one case respectively.
Of the 27 malignant cases the 3 and 5-year survival rates were 81.9% (22/27) and 62.9% (17/27) respectively, and one tumor free case living well more than 9 years. There were no recurrence in 10 cases with benign tumor.
Various craniofacial approaches except lateral rhinotomy provide directly satisfactory tumor exposure and facilitate enbloc resection of the naso paranasal sinus tumor with intracranial extension. Partial or total maxillary swing combined with naso pyramid translocation is good for tumor involving the skull base without intracranial invasion. The fronto-nasal pyramid translocation is good for removal of the upper part of nasal tumor with intracranial extension on well developed frontal sinus. The fronto orbital approach is proper for removal of fronto-sphenoid tumor and midface degloving may be used in selected cases.
研究前颅底肿瘤的手术入路。
对37例前颅底肿瘤患者进行手术治疗。21例行前颅面联合入路：8例行额下入路联合全上颌骨切除，5例行额下入路联合全上颌骨切除及眶内容物剜除，1例行额下入路联合鼻侧切开，7例行额下入路联合经鼻移位及上颌骨内侧切除。13例行部分或全上颌骨摆动联合鼻锥移位。分别有1例行额鼻、额眶及面中部掀翻入路。
27例恶性肿瘤患者中，3年和5年生存率分别为81.9%（22/27）和62.9%（17/27），1例无瘤生存超过9年。10例良性肿瘤患者均无复发。
除鼻侧切开外，各种颅面联合入路能直接提供满意的肿瘤暴露，便于整块切除侵犯颅内的鼻窦肿瘤。部分或全上颌骨摆动联合鼻锥移位适用于侵犯颅底但未侵犯颅内的肿瘤。额鼻锥移位适用于额窦发育良好且侵犯颅内的鼻上部肿瘤。额眶入路适用于额蝶部肿瘤的切除，面中部掀翻入路可用于特定病例。
