DeMonte F
Department of Neurosurgery, University of Texas MD Anderson Cancer Center, Houston 77030, USA.
Curr Opin Oncol. 1995 May;7(3):201-6. doi: 10.1097/00001622-199505000-00002.
The management of tumors arising from or, by extension, involving the skull base is complex due to the density and sensitivity of nearby neurovascular structures, the proximity of these structures to the relatively contaminated spaces of the paranasal sinuses or ear and mastoid, the varied pathologic entities encountered, and the relative lack of familiarity with the local anatomy. Dedicated multidisciplinary teams have formed in order to best diagnose, evaluate, and treat patients with these relatively rare disorders. Research in surgical anatomic laboratories continues to refine operative approaches and methods, whereas reevaluations of the methods of preoperative patient neurovascular assessment seek to identify the tests that provide the greatest predictive value with the least risk to the patient. The object of molecular genetic investigation of skull base tumors is to identify the mechanisms of tumorigenesis and possible therapeutic targets for intervention. Advances in surgical, radiotherapeutic, and chemotherapeutic techniques have expanded management options. In some instances, the traditionally adjuvant roles of radiation therapy (including radiosurgery) and chemotherapy have become viable primary forms of therapy. The rich multidisciplinary environment in which skull base surgery has developed has allowed for significant progress in the field and has improved patient outcomes.
由于颅底附近神经血管结构密集且敏感、这些结构靠近鼻旁窦或耳及乳突相对污染的区域、所遇到的病理实体多样以及对局部解剖结构相对缺乏了解，起源于颅底或累及颅底的肿瘤的治疗很复杂。为了对患有这些相对罕见疾病的患者进行最佳诊断、评估和治疗，专门的多学科团队已经组建。外科解剖实验室的研究不断完善手术入路和方法，而对术前患者神经血管评估方法的重新评估则致力于确定能以对患者风险最小的方式提供最大预测价值的检查。颅底肿瘤分子遗传学研究的目的是确定肿瘤发生机制以及可能的治疗干预靶点。手术、放射治疗和化学治疗技术的进步扩大了治疗选择。在某些情况下，放射治疗（包括立体定向放射外科）和化学治疗传统上的辅助作用已成为可行的主要治疗方式。颅底外科发展所处的丰富多学科环境使得该领域取得了重大进展并改善了患者预后。
