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目的探讨鼻内镜在鼻底鼻咽肿瘤切除手术中的应用价值。方法2001年1月~2005年1月共进行手术12例,其中鼻底肿瘤5例,鼻咽肿瘤7例。全部患者均在气管插管全麻,鼻内镜下经硬腭径路手术,其中3例鼻咽肿瘤术前采用血管造影并进行肿瘤供血动脉栓塞,术中根据需要采用控制性低血压技术。结果2例恶性肿瘤术中冷冻确诊后更改术式,其余10例术后硬腭黏骨膜瓣愈合良好,发音、吞咽、呼吸、咀嚼等功能正常,随访1年以上无复发。结论鼻内镜下经硬腭切除鼻底鼻咽肿瘤较传统硬腭径路手术有明显优势。
Objective To explore the value of endoscopic nasopharyngeal nasopharyngectomy. Methods From January 2001 to January 2005, 12 patients underwent surgery, including 5 cases of nasal floor tumors and 7 cases of nasopharyngeal tumors. All patients underwent general anesthesia with endotracheal intubation and endoscopic sinus surgery via palatal pathology. Three cases of nasopharyngeal neoplasms were treated with angiography before surgery and embolization of tumor-supplying artery. Controlled hypotension was used as needed during the operation. Results Two cases of malignant tumors were diagnosed by intraoperative frozen diagnosis. The remaining 10 cases of postoperative hard palate mucoperiosteal flap healed well. The functions of vocalization, swallowing, respiration and chewing were normal. No recurrence was found after more than one year of follow - up. Conclusions Endoscopic nasal endoscopic nasal pharyngeal resection of the nasal floor by the hard palate has obvious advantages over the traditional approach of palatal pathology.