Freitag V, Jaksche H
Abteilung für Mund-Kiefer-Gesichtschirurgie, Universitätskliniken Homburg/Saar.
Dtsch Z Mund Kiefer Gesichtschir. 1990 Mar-Apr;14(2):132-40.
Surgical treatment of fronto-maxillary tumors requires interdisciplinary cooperation of maxillofacial surgeons and neurosurgeons. Depending on the site and extension of the tumor, it may be necessary to resort to generous excision of the frontal, temporal, sphenoid, zygomatic bones, orbita and nasal bone, including their soft-tissue covers; possibly even exenteration of the orbita and excision of dura are required. Closure of open subarachnoid space is mandatory. Dural defects are supplied with periosteum or free fascial grafts. Calvarial defect are usually repaired with large rotation flaps of the scalp. In exceptional cases pedicled flaps from more remote areas or microsurgically vascularized grafts are used. The facial area is supplied either with flaps or split skin grafts, depending on the situation. Open paranasal sinuses must be drained via the nasal sinus. Remaining facial defects are treated prosthetically.
额上颌部肿瘤的外科治疗需要颌面外科医生和神经外科医生的多学科合作。根据肿瘤的部位和范围，可能需要对额骨、颞骨、蝶骨、颧骨、眼眶和鼻骨及其软组织覆盖物进行广泛切除；甚至可能需要进行眼眶内容剜除术和硬脑膜切除术。必须封闭开放的蛛网膜下腔。硬脑膜缺损用骨膜或游离筋膜移植物修复。颅骨缺损通常用头皮大旋转皮瓣修复。在特殊情况下，使用来自更远部位的带蒂皮瓣或显微外科血管化移植物。面部区域根据情况用皮瓣或中厚皮片修复。开放的鼻窦必须通过鼻窦引流。其余面部缺损采用修复术治疗。
