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目的：探讨侵犯前颅底筛窦肿瘤的手术方式及前颅底重建的方法．方法：对 １９９４～１９９８年间的４例侵犯前颅底的筛窦肿瘤采用额骨硬脑膜外进路颅面联合手术，分别用带蒂额骨膜瓣或帽状腱膜瓣及颅骨内板结合耳脑胶重建前颅底，结果：４例创口一期愈合，均未见脑脊液鼻漏及脑膜脑膨出，１例术后出现一过性尿崩症，１例术后视力提高，术后随访半年至５年，４例均存活．结论：额骨硬脑膜外入路颅面联合手术是切除侵犯前颅底筛窦肿瘤的有效方法，带蒂额骨膜瓣或帽状腱膜瓣与颅骨内板结合重建前颅底可有效地防止脑脊液鼻漏及脑膜脑膨出．
Objective: To explore the surgical method of invading the anterior skull base ethmoid sinus tumor and the method of anterior skull base reconstruction. METHODS: Four cases of ethmoid sinus invasion of the anterior skull base between 1994 and 1998 were treated with frontal dorso-dural extracranial craniofacial surgery. The pedicled periosteal or capular palpebral and skull internal plates were used in combination with the ear respectively. The anterior skull base was reconstructed with brain gel. Results: In 4 cases, the wounds were healed at one time. No cerebrospinal fluid leakage or meningocele was seen. One patient had transient diabetes insipidus after operation. One patient had improved visual acuity after operation. From six months to five years, all four cases survived. Conclusion: The combined craniofacial surgery of the frontal-brain-dural approach is an effective method to remove the invasion of the anterior skull base ethmoid sinus tumor. The reconstruction of the anterior skull base combined with the pedicled periosteal flap or cap-like decidua flap and the skull internal plate can effectively prevent CSF rhinorrhea and meningeal encephalocele.