Bébéar J P, Stoll D, Darrouzet V
C.H.U. Pellegrin Tripode, Clinique ORL, Bordeaux.
Rev Laryngol Otol Rhinol (Bord). 1990;111(3):203-6.
Based on 62 cases, the authors report on 14 years of experience of total ethmoidectomies through a mixed rhinological and neurosurgical approach. Following a survey of the main points of the surgical technique, they emphasize the major evolution undergone, on the one hand, by the preoperative topographic diagnostic possibilities thanks to progress in imaging, and, on the other hand, the operative technique itself. The optimization of the reconstruction time for the base of the skull seems to provide a substantial advantage by reducing morbidity and operative mortality. The use of the epicranial flaps and to a lesser degree, cryo-stored bone allografts are the major stages. Prognostically speaking, the mixed approach offers a clear improvement in the 5-year survival rate of adenocarcinomas (80%), and olfactory placode tumors. However, the prognosis for epidermoid carcinomas continues to be poor (35% at 5 years) due to the frequency of local recurrences and visceral metastases.
基于62例病例，作者报告了14年来通过鼻科和神经外科联合方法进行全筛窦切除术的经验。在概述手术技术要点后，他们强调了一方面由于影像学进展，术前地形诊断可能性所经历的重大演变，另一方面是手术技术本身。颅骨底部重建时间的优化似乎通过降低发病率和手术死亡率提供了实质性优势。使用头皮瓣以及程度较轻的冷冻保存同种异体骨是主要步骤。从预后角度来看，联合方法在腺癌（80%）和嗅基板肿瘤的5年生存率方面有明显改善。然而，由于局部复发和内脏转移的频率，表皮样癌的预后仍然很差（5年时为35%）。
