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目的 探讨额颞眶颧入路的特点及其切除颅中窝底肿瘤的手术技巧和适应证。方法 本入路是将额颞开颅颅骨切除的范围扩大到包括眶上缘、眶外侧壁及颧弓,以增加肿瘤的暴露,有利于肿瘤的切除。采用该方法对22例颅中窝底肿瘤进行手术,取得良好效果。其中脑膜瘤9例,垂体瘤8例,神经鞘瘤2例,脊索瘤2例,海绵状血管瘤1例。结果 获得肿瘤全切除者13例,次全切除6例,大部分切除3例,无手术死亡和严重手术并发症。结论 初步手术结果令人满意,该入路具有以下优点:①显露良好。可直视下切除的肿瘤范围广;②术野平面低,最大限度地减少了脑牵拉;③可从不同的方向显露并切除肿瘤,对同时侵袭颅内外、硬膜内外的肿瘤切除较彻底。
Objective To investigate the characteristics of the frontotemporal orbital zygomatic approach and the surgical techniques and indications for resection of the tumors in the midfacial fossa. Methods The approach is to expand the scope of the frontotemporal craniotomy to include the supraorbital margin, lateral orbital wall and zygomatic arch, in order to increase the exposure of the tumor is conducive to tumor resection. Twenty-two cases of tumors in the middle cranial fossa were surgically treated with this method and achieved good results. Including meningioma in 9 cases, 8 cases of pituitary tumors, Schwannoma in 2 cases, 2 cases of chordoma, cavernous hemangioma in 1 case. Results The total tumor resection in 13 cases, subtotal resection in 6 cases, most of the resection in 3 cases, no surgical death and serious complications. Conclusions The results of the initial surgery are satisfactory. The approach has the following advantages: (1) it is well exposed. Can be directly under the resection of a wide range of tumors; ② low surgical field, to minimize the brain stretch; ③ can be revealed from different directions and removal of the tumor, both at the same time invasion of intracranial and intradural tumors of the tumor resection more thoroughly .