Kawakami K, Yoshimura S, Matsumoto K, Kawamoto K, Tsuji H, Kyutoku S
Department of Neurosurgery, Kansai Medical University.
No Shinkei Geka. 1996 Jul;24(7):613-20.
The authors have previously reported on an extensive transbasal approach, through which a supraorbital bar is osteotomized. This operative technique has been applied by the authors not merely to benign but also to malignant tumors in the frontal skull base. However, in the operation for malignant tumors of the frontal base, it is important to resect en-bloc the tumors and surrounding tissues, such as dura of the skull base and the orbital contents. The authors describe the operative mode of the combined transbasal & transfacial approach and its good results in 19 cases with malignant tumors in the frontal skull base, and 3 types of en-bloc resection in this operative approach (from type A to C) are introduced. Type A of en-bloc resection in the combined transbasal & transfacial approach was performed in 11 cases with the tumors invading the ethmoid sinuses. Type B was performed in 4 cases with tumors extending to the orbit. Type C was performed in 4 cases with tumors extending to the orbit and the maxillary sinuses on the affected side. These operative modes are useful in skull base surgery.
作者之前报道过一种广泛的经基底入路，通过该入路可对眶上嵴进行截骨。作者不仅将这种手术技术应用于额颅底的良性肿瘤，也应用于恶性肿瘤。然而，在额底恶性肿瘤的手术中，整块切除肿瘤及周围组织，如颅底硬脑膜和眶内容物很重要。作者描述了经基底联合经面部入路的手术方式及其在19例额颅底恶性肿瘤中的良好效果，并介绍了该手术入路中的3种整块切除类型（从A到C型）。联合经基底和经面部入路的A型整块切除在11例肿瘤侵犯筛窦的病例中进行。B型在4例肿瘤延伸至眼眶的病例中进行。C型在4例肿瘤延伸至患侧眼眶和上颌窦的病例中进行。这些手术方式在颅底手术中很有用。
