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目的:探讨安全切除累及侧颅底的肿瘤的手术切口及其疗效。方法 :选择2008年8月—2015年8月收治的21例累及侧颅底的肿瘤患者,良性肿瘤13例,恶性肿瘤8例。其中5例采用头皮半冠状切口,8例采用改良FergusonWeber切口,7例采用耳前-下颌下切口,1例采用头皮半冠状-耳前-下颌下-改良Ferguson-Weber复合切口。结果 :20例患者的肿瘤均完整切除,1例上颌窦纤维肉瘤复发患者行姑息切除。所有手术患者均未出现围术期死亡及严重术中、术后并发症。8例恶性肿瘤中,5例术后予以放疗,3例术后予以化疗。恶性肿瘤患者术后3年生存率为50%(4/8)。结论 :对于累及侧颅底的肿瘤,应针对其所侵及的具体解剖结构,选择最适宜的手术切口。其中头皮半冠状切口、改良Ferguson-Weber切口、耳前-下颌下切口与复合切口较为常用,且均可达到手术目的,但又各有其侧重点。
Objective: To investigate the surgical resection and its curative effect of safely resecting the tumor involving the skull base. Methods: Twenty-one patients with side skull base tumors admitted in our hospital from August 2008 to August 2015 were selected, including 13 benign tumors and 8 malignant tumors. Among them, 5 cases received scalp semicircular incision, 8 cases modified Ferguson-Weber incision, 7 cases with auricle-submandibular incision and 1 case with scalp semicognition-anuricle-submandibular-modified Ferguson-Weber incision. Results: The tumors of 20 patients were completely resected. One patient with recurrence of maxillary sinus fibrosarcoma underwent palliative resection. Perioperative deaths and serious intraoperative and postoperative complications did not occur in all patients. Of 8 malignant tumors, 5 were treated with radiotherapy and 3 were treated with chemotherapy. The 3-year survival rate of patients with malignant tumors was 50% (4/8). Conclusion: For the tumors involving the skull base, the most suitable surgical incision should be selected according to the specific anatomy involved. Among them, scalp semicircular incision, modified Ferguson-Weber incision, pre-anterior-submandibular incision and composite incision are more commonly used, and can achieve the purpose of surgery, but each has its own focus.