Zhou L, Guo H, Li S, Ji Y, Huang F
Department of Neurosurgery, Huashan Hospital, Shanghai Medical University.
Chin Med J (Engl). 1995 Jun;108(6):407-12.
A modification of the transbasal approach of Dorome called extensive subfrontal approach and the surgical results with this approach in 22 cases are presented. Bilateral frontal craniotomies incorporated with the removal of orbital ridges and part of the orbital roofs were fashioned en bloc. It may give rise to good exposure of the midline lesions of the anterior, middle and posterior skull base, minimizing the need for the retraction of frontal lobes. There was no surgical mortality in this series of cases. Of the 20 cases with tumors, total resections were achieved in 11 cases, subtotal or large resections in 4 cases and partial resection in one case. Two patients with spontaneous rhinorrhea were successively treated surgically. 21 patients had a follow-up with a time ranging from 1-11 years (a mean of 3 years). 15 patients resumed their jobs with no evidence of recurrence of the original disease, and 5 patients able to live self-care. One patient with an olfactory neuroblastoma died 3 years after the operation owing to relapse of the tumor.
介绍了一种对多罗梅经基底入路的改良方法，即广泛的额下入路，并展示了采用该入路对22例患者进行手术的结果。采用双侧额部开颅术，整块切除眶嵴和部分眶顶。这样可以很好地暴露前、中、后颅底的中线病变，尽量减少额叶牵拉的需要。在这一系列病例中没有手术死亡。在20例肿瘤患者中，11例实现了全切除，4例实现了次全切除或大部切除，1例为部分切除。2例自发性鼻漏患者先后接受了手术治疗。21例患者进行了随访，随访时间为1至11年（平均3年）。15例患者恢复工作，无原发病复发迹象，5例患者能够自理生活。1例嗅神经母细胞瘤患者术后3年因肿瘤复发死亡。
