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我科自1975年～1985年间,共收治鼻咽血管纤维瘤30例。其中男性28例,女性2例;最大年龄37岁,最小14岁,平均为19岁。所有病例均行手术治疗,现将治疗过程中有关问题分析讨论如下。1 麻醉问题采用经口腔插管全麻,在剥离瘤体时控制低血压;如鼻咽部瘤体较大,或手术采用硬腭进路者,则采用气管切开插管全麻。2 手术进路问题30例中,我们采取鼻侧切开18例次(其中包括1例鼻侧切开+上唇切开),硬腭U形切口3例次,无切口经口鼻腔联合剥离9例次。经过这几种手术进路的比较,我们认为如肿瘤位于鼻咽部或仅侵入至鼻腔者,可选择经口鼻腔联合剥离法摘除瘤体。其优点:术中出血少,手
In our department from 1975 to 1985, 30 cases of nasopharyngeal angiofibroma were treated. There were 28 males and 2 females. The maximum age was 37 years and the minimum was 14 years. The average age was 19 years old. Surgical treatment was performed in all cases. Analysis and discussion of related problems in the treatment process are as follows. 1 The anesthetic problem is controlled by oral anesthesia with general anesthesia. When the tumor is removed, hypotension is controlled; if the nasopharyngeal tumor is large, or if a hard palate is used for surgery, tracheotomy is used for general anesthesia. 2 Among the 30 cases of surgical approach, we adopted 18 cases of nasal incision (including 1 case of nasal incision + upper lip incision), 3 cases of hard hernia U-shaped incision, no incision, 9 cases of joint oral and nasal dissection. Times. After the comparison of these surgical approaches, we believe that if the tumor is located in the nasopharynx or only invades the nasal cavity, the tumor can be removed by combined oral and nasal dissection. Its advantages: less bleeding during operation, hands