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经鼻内镜切除前颅底肿瘤的手术疗效与安全性

Surgical outcomes and safety of transnasal endoscopic resection for anterior skull tumors.

作者信息

Dave Sandeep P, Bared Anthony, Casiano Roy R

机构信息

Department of Otolaryngology-Head and Neck Surgery, Jackson Memorial Medical Center, Leonard M. Miller School of Medicine, University of Miami, Miami, FL, USA.

出版信息

Otolaryngol Head Neck Surg. 2007 Jun;136(6):920-7. doi: 10.1016/j.otohns.2007.01.012.

Abstract

OBJECTIVE

To report the surgical outcomes and safety of transnasal endoscopic resection (TER) for anterior skull base (ASB) tumors.

STUDY DESIGN AND SETTING

A retrospective chart review to identify patients undergoing TER for ASB tumors at a tertiary care medical center between September 1997 and June 2006.

RESULTS

Nineteen patients underwent TER for ASB tumors without open craniotomy. There were 17 malignant and two benign lesions. Olfactory neuroblastoma was the most common pathology, occurring in 53 percent of patients. One patient recurred locally, resulting in an overall local control rate of 94.7 percent for all neoplasms and 94.1 percent for malignant disease. It should be noted that the tumor control rate may be premature given the small sample size and limited follow-up. Overall, there were 16 complications, but only two of these, an orbital hematoma and a frontal lobe abscess, were considered major complications directly attributable to surgery.

CONCLUSIONS

TER for ASB tumors appears to be safe in properly selected patients. In light of the small sample size and limited follow-up, the major complication rate directly attributable to surgery was 11 percent, and the overall local control rate was 95 percent. A larger multi-institutional series with longer follow-up is warranted.

摘要

目的

报告经鼻内镜切除术(TER)治疗前颅底(ASB)肿瘤的手术效果及安全性。

研究设计与背景

一项回顾性病历审查,以确定1997年9月至2006年6月期间在一家三级医疗中心接受TER治疗ASB肿瘤的患者。

结果

19例患者接受了TER治疗ASB肿瘤,未行开颅手术。其中有17例恶性病变和2例良性病变。嗅神经母细胞瘤是最常见的病理类型,占患者的53%。1例患者局部复发,所有肿瘤的总体局部控制率为94.7%,恶性疾病的局部控制率为94.1%。鉴于样本量小和随访有限,肿瘤控制率可能为时过早。总体而言,有16例并发症,但其中只有2例,即眼眶血肿和额叶脓肿,被认为是直接归因于手术的主要并发症。

结论

对于经过适当选择的患者,TER治疗ASB肿瘤似乎是安全的。鉴于样本量小和随访有限,直接归因于手术的主要并发症发生率为11%,总体局部控制率为95%。有必要进行更大规模的多机构系列研究并进行更长时间的随访。

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