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目的:探讨侧颅底肿瘤切除术后缺损的修复。方法:回顾性总结132例侧颅底肿瘤切除术后缺损的修复及愈后情况。病种包括听神经瘤(92例),颈静脉孔肿瘤(21例),颞下窝肿瘤(6例),鼻咽癌放疗后复发癌(4例),中耳癌(3例),桥小脑角的脑膜瘤(2例),蛛网膜囊肿(2例),颞骨鳞状细胞癌2例。修复部位包括硬脑膜、颅底骨、颧弓、颅底颞下窝的缺损。采用的材料有腹壁脂肪(113例)、颞肌及颞肌筋膜瓣(29例)、胸锁乳突肌肌瓣(19例)、胸大肌皮瓣(2例)、人工脑膜(1例)、钛板(1例)。结果:采用的带血管颞肌及颞肌筋膜瓣、胸大肌皮瓣、胸锁乳突肌肌瓣全部存活,用脂肪修复成功率为98.2%(111/113),脑脊液漏2例,无颅内感染发生。结论:根据侧颅底脑肿瘤的部位和不同类型的缺损,采用不同的修复材料和方法,肿瘤切除后颅底缺损的修复重建对术后功能的保留和恢复,避免脑脊液漏、颅内感染的发生,有着至关重要的作用,是侧颅底肿瘤手术成功的关键之一。
Objective: To investigate the repair of defect after resection of lateral skull base tumor. Methods: Retrospective review of 132 cases of resection of lateral skull base tumor resection and healing after the situation. The disease included 92 cases of acoustic neuroma, 21 cases of jugular foramen, 6 cases of inferior temporal fossa tumor, 4 cases of recurrent nasopharyngeal carcinoma after radiotherapy, 3 cases of middle ear carcinoma, (2 cases), arachnoid cyst (2 cases) and temporal bone squamous cell carcinoma (2 cases). Repair sites include dura, skull base, zygomatic arch, skull base infratemporal fossa defects. Materials used were abdominal fat (113 cases), temporal and temporal fascia flap (29 cases), sternocleidomastoid muscle flap (19 cases), pectoralis major muscle flap (2 cases), artificial meninges Example), titanium plate (1 case). Results: The flap with the temporalis muscle and temporal muscle fascia, the pectoralis major muscle flap and the sternocleidomastoid muscle flap all survived. The success rate of fat repair was 98.2% (111/113), cerebrospinal fluid leakage in 2 cases, No intracranial infection occurs. Conclusion: According to the site and different types of defects of the skull base brain tumor, different repair materials and methods are used to repair and rehabilitate the skull base defect after tumor resection and preserve the function of the skull base to prevent cerebrospinal fluid leakage and intracranial infection Occurrence, has a vital role, is one of the key to the success of the operation of the lateral skull base tumor.