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目的:介绍改良外鼻锥体侧翻术在颅底肿瘤手术的临床应用。方法:回顾性研究改良外鼻锥体侧翻术治疗的20例颅底肿瘤的诊断及外科手术治疗结果。结果:20例颅底肿瘤均累及鼻腔、双侧筛窦、蝶窦及眶内侧壁。侵犯翼腭窝、颞下窝2例,侵犯颅内者2例;均行改良外鼻锥体侧翻术治疗,其中2例鼻咽纤维血管瘤患者同时行额颞颧开颅及大部分上颌骨移位手术;2例行颅面联合入路手术。术后10例患者行放疗。患者术后无手术并发症,随访8～60个月,有6例肿瘤复发。结论:改良外鼻锥体侧翻术是治疗鼻腔、筛窦、蝶窦肿瘤累及颅底的一种安全、有效的外科治疗方法;在肿瘤向翼腭窝、颞下窝及颅内侵犯时应辅以其他手术入路。
Objective: To introduce the clinical application of modified lateral nose cone surgery in skull base tumor surgery. Methods: The diagnosis and surgical treatment of 20 cases of skull base tumors treated by modified lateral nose cone surgery were retrospectively studied. Results: Twenty cases of skull base tumors all involved nasal cavity, bilateral ethmoid sinus, sphenoid sinus and medial orbital wall. Invasion of the pterygopalatine fossa, infratemporal fossa in 2 cases, 2 cases of invasion of the intracranial; were treated with modified lateral nose cone surgery, including 2 cases of nasopharyngeal fibrovascular tumor at the same time frontal temporal zygomatic craniotomy and most of the maxillary Bone shift surgery; 2 cases of craniofacial surgery. Ten patients underwent radiotherapy. No postoperative complications, follow-up 8 to 60 months, 6 cases of tumor recurrence. CONCLUSIONS: Modified lateral nose cone surgery is a safe and effective surgical treatment for nasal cavity, ethmoid sinus and sphenoid sinus involving the skull base. When tumors are infiltrating into the pterygopalatine fossa, infratemporal fossa and intracranial Supplemented by other surgical approach.