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目的研究经下颌入路切除颅中凹底与颞下窝沟通肿瘤和术后重建的方法。方法采用经下颌入路及与额颞联合入路对13例此区域肿瘤行显微手术切除,手术重建包括硬膜修补、手术残腔消除及骨固定。结果肿瘤全切除11例,次全切除1例,部分切除1例。无死亡及严重残疾。12例临床症状显著改善。2例出现并发症。结论经下颌入路及与额颞联合入路能提供良好的显露,可安全、彻底地切除肿瘤,提高病人生活质量。严格掌握手术指征,使用显微技术,可靠重建颅底,及重视病人术后的功能和美观等,是手术成功的关键。
Objective To study the method of resecting the tumor at the concave base of the skull and the infratemporal fossa through the mandibular approach and reconstruction after operation. Methods Thirteen patients with tumors in this region underwent microsurgical resection via the mandibular approach and frontotemporal approach. Surgical reconstruction included dura mater repair, surgical residual cavity elimination and bone fixation. Results Total resection in 11 cases, subtotal resection in 1 case, partial resection in 1 case. No death or serious disability. 12 cases of clinical symptoms improved significantly. 2 cases of complications. Conclusions The mandibular approach combined with the frontotemporal approach can provide a good indication of safety and complete removal of the tumor and improve patient quality of life. Strict control of surgical indications, the use of microscopy, reliable reconstruction of the skull base, and attach importance to the patient’s postoperative function and beauty, etc., is the key to the success of the operation.