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目的探讨侵袭颅内嗅神经母细胞瘤临床特点及治疗方法。方法对我院神经外科从2001年7月-2005年8月收治的5例侵袭颅内嗅神经母细胞瘤病人的临床表现、影像学特点、病理学特点,手术治疗进行分析,1例行内镜下经鼻活检,4例手术治疗,分别选择经额入路和经额扩展入路,应用不同方法进行颅底重建。全部病人术后行放疗,1例辅助化疗。术后6-45个月进行随访。结果4例侵袭颅内肿瘤全部切除,术后鼻塞全部改善,3例术前视力下降者术后视力均有一定程度的改善,术后均未发生脑脊液漏,2例术后出现腰骶段椎管内转移,分别为术后6-8个月。其中1例手术,死亡1例。结论侵袭颅内的嗅神经母细胞瘤治疗仍然需要多手段进行干预,对侵袭到颅内肿瘤要争取全切除,术后应辅以放疗。
Objective To investigate the clinical characteristics and treatment of intracranial olfactory neuroblastoma. Methods The clinical manifestations, imaging features, pathological features and surgical treatment of 5 patients with intracranial olfactory neuroblastoma admitted to our hospital from July 2001 to August 2005 were analyzed. One patient underwent in-line Microscopic nasal biopsy, 4 cases of surgical treatment, were selected by the amount of approach and expansion of the amount of approach, the application of different methods of skull base reconstruction. All patients underwent radiotherapy, 1 case of adjuvant chemotherapy. Follow-up was performed 6-45 months after operation. Results All 4 cases of intracranial tumors were excised and all postoperative nasal obstruction was improved. The visual acuity of 3 cases with preoperative visual acuity decreased to some degree after operation, no leakage of cerebrospinal fluid occurred after operation and 2 cases of postoperative lumbosacral spine Tube transfer, respectively, 6-8 months after surgery. One case of surgery, 1 died. Conclusion Intracranial olfactory neuroblastoma treatment still need more means to intervene, invasion of intracranial tumors to fight for total resection, postoperative radiotherapy should be supplemented.