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目的探讨采用经上颌骨翻转入路手术切除Al-MeftyⅢ型斜坡脊索瘤的方法及临床意义。方法对10例Al-MeftyⅢ型斜坡脊索瘤患者,采用经上颌骨翻转入路的手术方法切除肿瘤。术后随访10~56个月,平均34个月。结果8例患者在显微镜下肿瘤被全部切除,2例次全切除(切除90%以上)。3例患者分别在术后26、36、40个月带瘤生存,其余7例恢复正常生活。手术并发症包括:创腔感染1例,脑脊液漏1例,咽喉部肿胀致阻塞性通气困难1例,均经保守治疗痊愈。结论经上颌骨翻转入路手术切除Al-MeftyⅢ型斜坡脊索瘤具有显露充分、肿瘤切除彻底、不损伤脑组织的优点,疗效满意。
Objective To investigate the method and clinical significance of Al-Mefty Ⅲ type chordoma treated by maxillary inversion approach. Methods Ten patients with Al-Mefty Ⅲ type chordoma were treated by maxillary approach. The patients were followed up for 10 to 56 months with an average of 34 months. Results Eight patients underwent microsurgical resection of the tumor and two subtotal resections (more than 90% resection). Three patients survived with tumor at 26, 36 and 40 months postoperatively, respectively. The remaining 7 patients returned to normal life. Surgical complications included wound infection in 1 case, cerebrospinal fluid leakage in 1 case, and throat lashes caused by obstructive ventilation in 1 case, all of whom were cured by conservative treatment. Conclusion Surgical removal of Al-Mefty Ⅲ type chordoma by maxillary inversion approach has the advantages of adequate exposure, thorough tumor resection, no damage to brain tissue and satisfactory curative effect.