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目的:探讨未突破眶筋膜及硬脑膜的鼻眶颅沟通瘤经鼻入路内镜手术治疗的可行性。方法:9例未突破眶筋膜及硬脑膜的鼻眶颅沟通瘤患者,颅底骨质缺损大小为1.25cm×1.13cm~3.25cm×2.69cm,经鼻入路内镜下手术治疗,均保留眼球,未进行颅底和眶内侧壁重建,用碘仿纱条填塞术腔14d。恶性病变者术后再进行放化疗。结果:内镜下均完全切除肿瘤,术中输血1例,无眶、颅并发症,术后颅底、眶壁骨质增生自动修复缺损。术后随访2年,复发3例,其中死亡2例。结论:在一定程度上,瘤体主体在鼻腔鼻窦的鼻眶颅沟通瘤,经鼻入路内镜手术是一种安全、可靠、有效的治疗方法。
Objective: To investigate the feasibility of transnasal endoscopic surgery without penetrating the orbital fascia and dura mater of the nasion orbital cranioma. Methods: Nine patients with orbital craniocerebellar tumor who did not break the orbital fascia and dura were included. The size of the skull base defect was 1.25cm × 1.13cm ~ 3.25cm × 2.69cm, and were treated by endoscopic nasal approach Keep the eye, not skull base and orbital wall reconstruction, with iodoform gauze packing cavity 14d. Malignant lesions were treated with radiotherapy and chemotherapy. Results: Tumor was completely removed under endoscopy. One case of intraoperative blood transfusion, no orbital and cranial complications, postoperative skull base, orbital bone hyperplasia automatically repair the defect. Follow-up 2 years after surgery, 3 cases of recurrence, of which 2 died. Conclusion: To a certain extent, the main body of the tumor in the naso-orbital craniofacial tumor, transnasal endoscopic surgery is a safe, reliable and effective treatment.