Xu C L, Liang J P, Lu Q T, Zhang S J
Department of Otolaryngology, People's Hospital of Guangxi Zhuang Autonomous Region, Nanning, 530021, China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2017 Aug 20;31(16):1276-1280. doi: 10.13201/j.issn.1001-1781.2017.16.014.
This paper is intend to observe the feasibility of surgical approach with which communicating neoplasm outside cerebral dura mater and orbital fasciae was removed by transnasal endoscopic surgery.Nine patients suffered from communicating neoplasm in the area of naso-orbital-cranio complex were treated with transnasal endoscopic surgery. The size of skull base bone defect was from 1.25 cm×1.13 cm to 3.25 cm×2.69 cm. No eye enucleation was done. No reconstructions of skull base and medial wall of orbital cavity were done. Iodoform gauze was packed in paranasal sinuses fourteen days. Patients with malignant tumor were treated radiation therapy and chemical therapy after surgical treatment. The degree of resection, complications of intracranial and orbital cavities, survival condition were the focus of this study.The tumor were completely removed and all operations were successfully completed by trasnasal endoscopic surgery. Only one patient was required blood transfusion due to seriously bleeding from tumor during the operation. There was no orbital, intracranial, and vascular complications. The defect of bone at skull base and lamina papyracea were automatic reconstructed. Three patients have showed recurrence of neoplasm, and two of them died during two years of following up time.Transnasal endoscopic surgery is a safe, reliable and effective approach to treat communicating neoplasm in the area of naso-orbital-cranio complex, of which main part of tumor exists in the sinunasal cavity.
本文旨在观察经鼻内镜手术切除脑硬膜外及眶筋膜外交通性肿瘤手术入路的可行性。9例鼻眶颅底区域交通性肿瘤患者接受了经鼻内镜手术治疗。颅底骨缺损大小为1.25 cm×1.13 cm至3.25 cm×2.69 cm。未行眼球摘除术。未进行颅底及眶腔内侧壁重建。碘仿纱条填塞鼻窦14天。恶性肿瘤患者术后接受放疗和化疗。本研究重点关注切除程度、颅内及眶腔并发症、生存情况。经鼻内镜手术完全切除肿瘤，所有手术均顺利完成。仅1例患者因术中肿瘤严重出血需要输血。无眶、颅内及血管并发症。颅底及纸样板骨质缺损自动修复。3例患者肿瘤复发，其中2例在随访2年内死亡。经鼻内镜手术是治疗鼻眶颅底区域交通性肿瘤的一种安全、可靠且有效的方法，此类肿瘤主要位于鼻窦腔。
