Johns M E, Winn H R, McLean W C, Cantrell R W
Laryngoscope. 1981 Jun;91(6):952-9. doi: 10.1288/00005537-198106000-00013.
Malignant neoplasms involving the ethmoid sinuses mandate en bloc resection via the craniofacial approach. This technique leaves a direct communication between the nasal chamber and the extradural space to be closed. The elevation of dura from the nasal chamber and the extradural space to be closed. The elevation of dura from the anterior chamber and the extradural space to be closed. The elevation of dura from the anterior cranial fossa and cribriform area may result in small dural tears, CSF leak and/or CNS infections. We have utilized an inferiorly based pericranial flap and a laterally based osteoplastic bone flap to successfully close this space and dural defects. The laterally based bone flap allows insetting pericranial flap without compromising the vascularized inferior base and gives generous exposure of the area to be resected. This approach has been used successfully in four patients in the last year. Three patients had esthesioneuroblastomas and the fourth had a squamous cell carcinoma of the maxilloethmoid complex. This communication describes the technique and lists advantages of the inferiorly based pericranial flap.
累及筛窦的恶性肿瘤需要通过颅面入路进行整块切除。该技术会留下鼻腔与硬脑膜外间隙之间的直接通道需要封闭。从鼻腔和硬脑膜外间隙抬起硬脑膜以进行封闭。从前房和硬脑膜外间隙抬起硬脑膜以进行封闭。从前颅窝和筛板区域抬起硬脑膜可能会导致硬脑膜小撕裂、脑脊液漏和/或中枢神经系统感染。我们采用了带蒂的颅周皮瓣和带蒂的骨成形骨瓣来成功封闭该间隙和硬脑膜缺损。带蒂的骨瓣允许嵌入颅周皮瓣，而不会损害血管化的下部蒂，并能充分暴露待切除区域。去年，该方法已在4例患者中成功应用。3例患者患有嗅神经母细胞瘤，第4例患有上颌筛窦复合体鳞状细胞癌。本交流描述了该技术，并列出了带蒂颅周皮瓣的优点。
