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目的 :探讨鼻腔鼻窦肿瘤侵犯前颅底的手术方法。方法 :经眉弓额窦前径路切除侵犯前颅底的鼻腔、鼻窦肿瘤 14例 ,7例前颅底骨质破坏直径在 2cm以下 ,硬脑膜完整者未行前颅底修复 ;7例既有前颅底骨质破坏 ,又有硬脑膜缺损且直径在 2 .5cm以上者 ,以带蒂额肌骨膜瓣、帽状腱膜额骨膜瓣或带蒂颞肌筋膜骨膜瓣修复。结果 :术后随访 1～ 8年 ,11例恶性肿瘤中 ,2年存活 1例 ,3年存活 6例 ,4年存活 2例 ,术后 2年内死亡 2例 ;3例良性肿瘤均健在。所有病例均未发生颅内外感染、脑脊液漏及脑膜脑组织膨出。结论 :该术式接近病变部位 ,各鼻窦暴露满意 ,可直视下进行手术操作 ,并减轻了对额叶的牵拉作用 ,修补脑膜及止血均方便 ,是治疗累及前颅底肿瘤较好的手术方法
Objective: To explore the method of nasal sinus tumor invasion of the anterior skull base. Methods: Nasal cavity and nasal sinus tumors were implanted in 14 cases of anterior skull base by anterior frontal sinus approach. The destructive diameter of the anterior skull base was below 2 cm in 7 cases. The anterior skull base was not repaired in the intact dura. Anterior skull base bone destruction, and dura mater defects and diameter of more than 2.5cm, pedicled with pedicled periosteal flap, the front of the popliteal flap or pedicled temporal muscle fascia periosteal flap repair. Results: All patients were followed up for 1 to 8 years. Among 11 malignant tumors, 1 patient survived 2 years, 6 survived 3 years, 2 survived 4 years, and 2 died 2 years after operation. All the 3 benign tumors were alive. No cases of intracranial infection, cerebrospinal fluid leakage and meningeal brain tissue bulging. CONCLUSIONS: The procedure is close to the lesion site, and the satisfactory sinus exposure can be performed under direct vision and relieve the pulling effect on the frontal lobe. It is convenient to repair the meninges and hemostasis, which is a good treatment for patients with anterior skull base tumors Surgical methods