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目的 探讨颅鼻沟通肿瘤的显微手术切除与颅底重建的适应症及手术入路选择。方法 总结我院收治的 38例颅鼻沟通肿瘤 ,经CT或MRI扫描确诊 ,手术选择经鼻侧入路或颅鼻联合入路 ,显微镜下切除肿瘤并行颅底修复重建。结果 肿瘤全切除 2 3例 ,次全切除 8例 ,大部分切除 7例 ,无手术死亡。随访 2～ 5年 ,30例病人 ,2 2例恢复原来的工作 ,2～ 3年内肿瘤复发 3例 ,再次手术切除。 1～ 4年内 5例恶性肿瘤多处转移、死亡。结论根据肿瘤的大小与累及范围选择鼻侧入路或颅鼻联合入路 ,显微镜下切除肿瘤或颅底重建是颅鼻沟通肿瘤切除的安全有效方法。
Objective To investigate the indications of microsurgical resection and skull base reconstruction in the cranio-nasal tumor and the choice of surgical approach. Methods Thirty-eight patients with craniocervical tumors treated in our hospital were diagnosed by CT or MRI scan. The patients underwent nasal approach or craniofacial approach. The tumors underwent microsurgical resection and reconstruction of skull base. Results Totally resection of the tumor in 23 cases, subtotal resection in 8 cases, the majority of resection in 7 cases, no operative death. After 2 to 5 years of follow-up, 30 patients, 22 patients restored their original work, 2 to 3 years tumor recurrence in 3 cases, resected again. Five cases of malignant tumor metastasized and died in 1 ~ 4 years. Conclusion According to the size of the tumor and the extent of involvement of the nasal approach or the combination of cranial and nasal approach, removal of the tumor under the microscope or cranial base reconstruction is a safe and effective method of tumor resection.