Yang Xiaotong, Yan Bo, Wei Wei, Liu Junqi, Wang Zhenlin
Department of Otorhinolaryngology Head and Neck Surgery,Skull Base Surgery Center,Xuanwu Hospital,Capital Medical University,Beijing,100053,China.
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2024 Dec;38(12):1127-1133. doi: 10.13201/j.issn.2096-7993.2024.12.007.
To explore the surgical techniques and clinical outcomes of endoscopic transnasal approaches in the treatment of skull base chondrosarcomas. Data from patients diagnosed with skull base chondrosarcomas and treated via endoscopic transnasal surgery at the Department of Otorhinolaryngology and Head and Neck Surgery, Xuanwu Hospital, Capital Medical University, from 2013 to 2022 were collected. This retrospective study analyzed the patients' clinical presentations, histopathological grading, involved sites and extents, and complications following the endoscopic transnasal surgery. Disease-free survival rates were calculated using the Kaplan-Meier method. Complete data from 31 patients showed that the primary tumor site was in the petroclival region in 27 cases(87%), and the anterior skull base in 4 cases(13%). Pathological grades were Grade Ⅰ(12 cases), Grade Ⅱ(16 cases), and Grade Ⅲ(3 cases). Total resection was achieved in 25 cases, with residual disease post-surgery in 6 cases. The average follow-up duration was 35.7 months(ranging from 6 to 120 months). Among those who achieved complete resection, recurrence occurred in 5 cases(5/25), with a five-year disease-free survival rate of 80%. Postoperative complications included transient abducens nerve palsy in 6 patients and cerebrospinal fluid rhinorrhea in 4 patients. There were no cases of death or permanent cranial nerve palsy. Total resection rate(=0.001) and involvement of the cerebellopontine angle and jugular foramen(=0.037) were identified as independent risk factors for residual disease and recurrence of chondrosarcoma. The endoscopic transnasal approach is a safe and feasible treatment option for skull base chondrosarcomas.
探讨鼻内镜经鼻入路治疗颅底软骨肉瘤的手术技巧及临床疗效。收集2013年至2022年在首都医科大学宣武医院耳鼻咽喉头颈外科经鼻内镜手术治疗的颅底软骨肉瘤患者资料。本回顾性研究分析了患者的临床表现、组织病理学分级、病变部位及范围,以及鼻内镜经鼻手术后的并发症。采用Kaplan-Meier法计算无病生存率。31例患者的完整数据显示,原发肿瘤部位位于岩斜区27例(87%),前颅底4例(13%)。病理分级为Ⅰ级12例,Ⅱ级16例,Ⅲ级3例。25例实现了全切除,6例术后有残留病灶。平均随访时间为35.7个月(6至120个月)。在实现完全切除的患者中,5例(5/25)复发,五年无病生存率为80%。术后并发症包括6例短暂性外展神经麻痹和4例脑脊液鼻漏。无死亡或永久性脑神经麻痹病例。全切除率(=0.001)以及桥小脑角和颈静脉孔受累(=0.037)被确定为软骨肉瘤残留病灶和复发的独立危险因素。鼻内镜经鼻入路是治疗颅底软骨肉瘤的一种安全可行的治疗选择。