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目的:探讨颅底肿瘤面骨移位入路手术切除的可行性、方式和临床效果。方法:总结我院口腔科联合神经外科自2003年2月—2007年7月收治且行面骨移位入路手术切除的14例颅底肿瘤患者的临床资料。手术采用上颌骨LeFortⅠ型截骨加上颌骨正中劈开显露6例,一侧上颌骨截骨外旋显露5例,颧骨、颧弓和下颌支截骨旋转显露3例。全部病例术后随访0.5～4a,评价手术疗效和术后并发症。结果:全部患者手术顺利,均达到良好的手术显露,术中及术后无严重手术并发症。9例良性肿瘤,无1例复发;5例恶性肿瘤中,1例术后1年复发,开颅二次手术后颅内感染死亡;生存1年以上1例,2年以上2例,3年以上1例。结论:面骨移位方式可以为颅底肿瘤的手术切除提供显露良好的手术入路。
Objective: To investigate the feasibility, method and clinical effect of surgical removal of skull base tumor by facet dislocation approach. Methods: To summarize the clinical data of 14 cases of skull base tumor patients who underwent face-to-face shift surgery from February 2003 to July 2007 in Department of Stomatology and Neurosurgery in our hospital. Six cases of maxillary osteotomy with maxillary osteotomy and five cases of maxillary osteotomy were revealed in the operation. Three cases were found with zygoma, zygomatic arch and mandibular branch osteotomy. All patients were followed up 0.5 ~ 4a, evaluation of surgical efficacy and postoperative complications. Results: All the patients underwent surgery successfully, both of which achieved good surgical findings and no serious surgical complications during and after operation. 9 cases of benign tumors, no recurrence of one case; 5 cases of malignant tumors, 1 case 1 year after recurrent craniotomy after intracranial infection died; survival of more than 1 year in 2 cases, 2 cases, 3 years More than one case. Conclusion: Bone displacement can provide a good surgical approach for the surgical resection of skull base tumors.