Stapleton S R, Wilkins P R, Archer D J, Uttley D
Department of Neurosurgery, Atkinson Morley's Hospital, London, England.
Neurosurgery. 1993 Mar;32(3):348-55; discussion 355-6. doi: 10.1227/00006123-199303000-00003.
Chondrosarcomas of the skull base are indolent, locally invasive tumors with a marked tendency to recur. Surgery is the mainstay of treatment because these tumors are generally resistant to other forms of treatment. A surgical approach with wide access to the skull base and one that is easily repeatable is required, because recurrence is common. We have used the LeFort I maxillotomy or mobilization of the zygoma at the time of craniotomy to obtain wide access to the skull base in eight cases of chondrosarcoma. Three patients have undergone subsequent procedures by us for recurrent disease. One patient died 30 days after the operation, and one has required an open repair of a cerebrospinal fluid leak. Good palliation of symptoms has been achieved in all survivors. These approaches fulfill the criteria for the surgical management of these difficult tumors by allowing excellent exposure, safe repetition if required, satisfactory palliation, and acceptable morbidity.
颅底软骨肉瘤是生长缓慢、具有局部侵袭性的肿瘤，且有明显的复发倾向。手术是主要的治疗手段，因为这些肿瘤通常对其他治疗方式耐药。由于复发很常见，所以需要一种能够广泛显露颅底且易于重复实施的手术入路。我们对8例软骨肉瘤患者采用了LeFort I型上颌骨切开术或开颅时颧骨松动术，以广泛显露颅底。3例患者因疾病复发接受了我们后续的手术治疗。1例患者术后30天死亡，1例患者需要对脑脊液漏进行开放性修补。所有存活患者的症状均得到了良好缓解。这些手术入路通过实现良好的显露、必要时安全的重复操作、令人满意的症状缓解以及可接受的并发症发生率，满足了这些难治性肿瘤手术治疗的标准。
