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目的评价上颌骨翻转入路在鼻咽咽旁颅底及颞下窝肿瘤手术中的应用。方法回顾1995年1月—2005年1月中国医科院肿瘤医院头颈外科应用上颌骨翻转入路手术切除60例鼻咽、咽旁颅底及颞下窝肿瘤。51例原发于鼻咽或中颅底,9例原发颞下窝。13例良性肿瘤,47例为恶性肿瘤,其中28例术前接受过放射治疗。结果全部病例无手术相关的较重的功能障碍及外观畸形。常见并发症是腭鼻漏12例及部分骨坏死2例,均见于鼻咽癌放疗后患者。用kaplan-Meier法计算恶性肿瘤累积5年生存率与无瘤生存率分别为76·4%和36·3%,良性肿瘤分别为100%和90%。结论上颌骨翻转入路在处理头颈鼻咽、咽旁颅底及颞下窝肿瘤时被证明是良好的选择之一,该手术路径为这些区域提供良好的手术显露和肿瘤的安全切除,以最低限度的外貌和功能影响及较少的并发症而可获得好的治疗效果。
Objective To evaluate the application of the maxillary overturning approach in nasopharyngeal parapharyngeal skull base and infratemporal fossa tumors. Methods From January 1995 to January 2005, 60 cases of nasopharyngeal, parapharyngeal skull base and infratemporal fossa tumors were surgically excised by maxillary inversion approach in head and neck surgery of Cancer Hospital of Chinese Academy of Medical Sciences. 51 cases of primary in the nasopharynx or middle skull base, 9 cases of primary infratemporal fossa. Thirteen cases of benign tumors and 47 cases of malignant tumors, of which 28 cases received preoperative radiotherapy. Results All the cases had no operative related severe dysfunction and appearance deformity. Common complication is palatal and nasal leakage in 12 cases and 2 cases of partial osteonecrosis, were found in patients with nasopharyngeal carcinoma after radiotherapy. The cumulative 5-year survival rate and tumor-free survival rate of malignant tumors calculated by kaplan-Meier method were 76.4% and 36.3% respectively, and benign tumors were 100% and 90% respectively. Conclusions Maxillary turnover approach proved to be a good choice in the treatment of head and neck nasopharynx, parapharyngeal skull base, and infratemporal fossa tumors, which provides good surgical exposure and safe tumor removal in these areas, with the lowest Limit the appearance and function of the impact and less complications and good treatment can be obtained.