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目的总结颅中窝内外沟通性肿瘤的显微外科治疗经验。方法回顾性分析16例颅中窝内外沟通性肿瘤病人的显微外科治疗经验。单纯采取额颞颧入路切除肿瘤13例,联合上颌窦前入路1例,联合下颌骨截断外旋2例。结果肿瘤全切除12例,次全切除4例。术后近期并发症:脑神经损伤6例,脑脊液漏2例,咬合错位2例,及伤口感染1例。无手术死亡。结论颅中窝沟通性肿瘤主要采用额颞颧手术入路切除,术中将颧弓断离,切除髁状突,释放脑脊液以降低颅内压,结合显微外科良好的照明、灵活的头位变换,可以较好地暴露并切除肿瘤。肿瘤广泛累及咽旁间隙时,可截断下颌骨扩大后部视野,保证手术安全。
Objective To summarize the experience of microsurgical treatment of intracranial tumors in medial and lateral tumors. Methods The microsurgical treatment experience of 16 patients with intracranial tumors in medial and lateral tumors was retrospectively analyzed. Thirteen cases of tumors were removed by frontotemporal zygomatic approach alone. One case was combined with anterior approach to the maxillary sinus and two cases were combined with truncated external rotation of the mandible. Results Tumor resection in 12 cases, subtotal resection in 4 cases. Short-term complications: 6 cases of cranial nerve injury, 2 cases of cerebrospinal fluid leakage, 2 cases of occlusion dislocation and 1 case of wound infection. No surgery died. Conclusions The tumors in the medial fossa are mainly resected by frontotemporal zygomatic approach. The zygomatic arch is severed during operation, the condyle is removed, the cerebrospinal fluid is released to decrease the intracranial pressure, combined with the good illumination of microsurgery and the flexible head position Transform, you can better expose and excision of the tumor. Tumor extensive involvement of parapharyngeal space, the jaw can be cut off to expand the field of vision, to ensure the safety of surgery.