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目的 :探讨累及前颅底或颅内脑组织的鼻腔副鼻窦癌的手术切除途径及方法。方法 :经颅面联合进路行显微外科连续整块切除累及前颅底或颅内脑组织的鼻腔副鼻窦癌 15例 ,其中 5例仅累及前颅底 ,10例累及前颅底至颅内额叶脑组织。硬脑膜缺损应用大腿阔筋膜修补。结果 :15例均作了术后随访 ,随访时间最长为 10年 ,最短为 2年。其中 4例为初治患者 ,11例为综合治疗后局部复发患者。 9例无瘤生存 2年以上 ,2年无瘤生存率为60 .0 0 %。 11例接受此手术行拯救外科治疗 ,其中 6例无瘤生存 2年以上 ,2年拯救成功率为 5 4 .5 5 %。结论 :经颅面联合进路行显微外科连续整块切除累及前颅底或颅内脑组织的鼻腔副鼻窦癌是可行的
Objective: To investigate the surgical approach and method of nasal sinus cancer involving the anterior skull base or intracranial brain tissue. Methods: Fifteen cases of nasal sinus cancer involving the anterior skull base or intracranial brain tissue were excised by continuous craniofacial microsurgery. Among them, 5 cases only involved the anterior skull base and 10 cases had anterior skull base to cranial skull Internal frontal lobe brain tissue. Application of dura laminectomy fascia repair. Results: All 15 patients were followed up for a maximum of 10 years and the shortest was 2 years. Among them, 4 were newly diagnosed patients and 11 were patients with local recurrence after comprehensive treatment. Nine patients survived more than 2 years without disease, and the 2-year disease-free survival rate was 60.0%. Of the 11 patients who underwent surgical resection, surgical rescue was performed in 6 of them, with 6 patients surviving for more than 2 years and a successful rescue rate of 54.55% at 2 years. CONCLUSIONS: Transcranial facial approach combined with microsurgical continuous en bloc resection of nasal sinusoids involving the anterior skull base or intracranial brain is feasible