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目的 :探讨前中颅底沟通瘤的手术入路和颅底重建的方法。方法 :采用经额鼻筛眶入路、经额颞眶颧入路和经额颞联合耳前颞下入路暴露肿瘤 ,予于显微手术切除。结果 :17例该部位肿瘤施行显微手术治疗 ,肿瘤全切除 11例 ,次全切除 3例 ,大部分切除 3例。手术结果良好 ,无手术死亡及严重并发症。结论 :前中颅底内外沟通瘤应根据肿瘤位置、侵犯范围选择适当手术入路 ,充分暴露病灶 ,有利于广泛切除肿瘤。颅底重建是避免脑脊液漏及颅内感染的关键。
Objective: To explore the method of surgical approach and cranial base reconstruction of anterior middle skull base tumor. Methods: Nasobasal orbital approach was used. The tumors were exposed through frontotemporal zygomatic approach and frontotemporal infratemporal approach via frontotemporal approach. The tumors were excised microsurgically. Results: Twenty-seven patients underwent microsurgical treatment of the tumor in this site. Tumor resection was performed in 11 cases, subtotal resection in 3 cases and resection in 3 cases. Good surgical results, no operative deaths and serious complications. Conclusion: The tumors in the anterior and middle cranial base should be treated according to the location of the tumor and the appropriate scope of the invasion. The full exposure of the lesion is beneficial to the extensive excision of the tumor. Skull base reconstruction is the key to avoid leakage of cerebrospinal fluid and intracranial infection.