Desaulty A, Lozes G, Gelaude A, Vankemmel B, Jomin M
Ann Otolaryngol Chir Cervicofac. 1987;104(1):29-36.
Four patients with cancer of ethmoid with extension to base of skull were treated by total ethmoidectomy through a subfrontal and transmaxillary approach, the complementary paralateronasal approach being necessary in only one case. Apart from the approach routes, particular features of the technique used were essentially the size of the frontal flap extending to orbital roof, and mainly the confection of a pericranial flap formed of epicranial aponeurosis lined with frontoparietal periosteum and pedunculated at the orbital border. Exposure of the tumor by the neurosurgical and sublabial transmaxillary route allows correct excision of cancers extending to cribriform plate. The pericranial plate completes the traditional base of skull plastic operation and appears to reduce risk of cerebromeningeal complications. The technique is proposed for cancer infiltrating meninges: it is valid whatever the age of patients.
4例筛窦癌侵犯颅底患者采用经额下和经上颌入路的全筛窦切除术治疗，仅1例需要辅助经鼻旁入路。除入路途径外，所用技术的特殊之处主要在于延伸至眶顶的额部皮瓣大小，以及主要由覆盖额顶骨骨膜的帽状腱膜形成并在眶缘带蒂的颅骨膜瓣的制作。经神经外科和经唇下上颌入路暴露肿瘤，能够正确切除侵犯筛板的癌症。颅骨膜瓣完善了传统的颅底整形手术，似乎降低了脑脊膜并发症的风险。该技术适用于浸润脑膜的癌症：无论患者年龄多大均有效。
