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目的总结内镜下扩大经鼻蝶入路鞍区及鞍旁区多层技术重建颅底的经验。方法回顾性分析12例鞍区及鞍旁区肿瘤的临床资料,其中颅咽管瘤4例,鞍区脑膜瘤3例,巨大垂体腺瘤5例;均行内镜下扩大经鼻蝶入路肿瘤切除术,并采用多层技术进行颅底重建。结果所有病例肿瘤均达全切除,颅底重建均1次修补成功。术后部分临床症状明显改善。随访3～6个月,均未出现脑脊液漏、细菌性脑膜炎和张力性气颅等并发症。结论内镜下扩大经鼻蝶入路术中多层技术重建颅底是一种简单、安全、有效的方法。
OBJECTIVE: To summarize the experience of endoscopic reconstruction of the base of the skull base by the multi-layer technique of the transsphenoidal approach and the parasellar approach. Methods The clinical data of 12 cases of sellar region and parasellar region were retrospectively analyzed. Among them, 4 were craniopharyngioma, 3 were meningioma in sella and 5 were giant pituitary adenoma. Tumor resection and multi-layer skull base reconstruction. Results All cases of tumors were up to total resection, skull base reconstruction were a successful repair. Some postoperative clinical symptoms improved significantly. All the patients were followed up for 3 to 6 months. No complications such as cerebrospinal fluid leakage, bacterial meningitis and tension pneumocephalus were observed. Conclusions It is a simple, safe and effective method to reconstruct the base of skull by multi-layer technique of endoscopic transnasal approach.