Kuriakose Moni Abraham, Trivedi Nirav P, Kekatpure Vikram
Department of Head and Neck Oncology, Mazumdar Shaw Cancer Center Narayana Health City, Bangalore, 560 099 India.
Indian J Surg Oncol. 2010 Apr;1(2):133-45. doi: 10.1007/s13193-010-0027-5. Epub 2010 Nov 21.
The basic principle of anterior skull base surgery is to provide adequate exposure to enable three dimensional resection of skull base tumors. Negative surgical margins, which is within the control of surgeon, is the principle prognostic factor in anterior skull base tumors. Open skull base approaches is the standard of care for malignant anterior skull base tumors. Benign lesions may be resected by alternate minimally invasive approaches. Advances in anterior skull base surgery, in particular the facial translocation approaches allows wide exposure of the tumors with minimal retraction of the brain. The outcome of anterior skull base tumors have steadily increased over the years with disease free survival comparable to other malignant neoplasm of the head and neck region. This review described various surgical approaches and pertaining anatomy and pathology of anterior skull base tumors.
前颅底手术的基本原则是提供充分的暴露,以实现颅底肿瘤的三维切除。手术切缘阴性是前颅底肿瘤的主要预后因素,这一点由外科医生控制。开放颅底入路是治疗恶性前颅底肿瘤的标准方法。良性病变可通过其他微创方法切除。前颅底手术的进展,特别是面部移位入路,可在对脑牵拉最小的情况下广泛暴露肿瘤。多年来,前颅底肿瘤的治疗效果稳步提高,无病生存率与头颈部其他恶性肿瘤相当。本文综述了前颅底肿瘤的各种手术入路以及相关的解剖学和病理学。