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目的:讨论不同区域颅底肿瘤的发生和组织来源的关系以及治疗方法的选择。方法:收集232例与颅底解剖区域有关的良、恶性肿瘤病例资料,分析哪些组织来源的肿瘤易接近或易侵犯颅底的哪些区域,不同区域的肿瘤选择了何种手术进路和治疗方法。结果:达颅前窝的肿瘤40例,其中上颌骨鳞癌23例、肉瘤7例、粘液瘤3例、造釉细胞瘤7例;达卵圆孔至茎突连线以外区域(包括颞下窝)70例,其中下颌骨升支部恶性肿瘤43例、腮腺恶性肿瘤复发者9例(腺样囊性癌4例)、耳颞区皮肤癌复发者3例、髁状突骨瘤及骨软骨瘤10例、神经来源肿瘤5例,达卵圆孔至茎突连线以内斜坡外侧区域114例,其中神经鞘瘤60例、脑膜瘤9例、肉瘤12例、低分化硬癌4例、颈动脉体瘤16例(指抵达颅底的部分病例)、腮腺来源肿瘤13例;枕骨大孔附近8例,其中脑膜瘤2例、脊膜瘤3例、神经鞘瘤3例。结论:在能够接近或破坏颅底组织的肿瘤中发现,肿瘤组织来源不同,易发区域也有所不同。因此根据肿瘤发生的区域,可以初步判断肿瘤的组织来源,有利于诊断和鉴别诊断,同时可以帮助选择较为合理的手术进路。
OBJECTIVE: To discuss the relationship between the occurrence of skull base tumors in different regions, the origin of tissues and the choice of treatment methods. Methods: The data of 232 cases with benign and malignant tumors related to skull base anatomy were collected and analyzed. Which of the tissue-derived tumors were easily accessible or easy to violate the areas of skull base, and which surgical approaches and treatments were selected by tumors in different regions? . Results: 40 cases of anterior cranial fossa tumor, including 23 cases of maxillary squamous cell carcinoma, 7 cases of sarcoma, 3 cases of myxoma, ameloblastoma in 7 cases; up to the foramen ovale to the styloid process outside the area (including the infratemporal Fossa) 70 cases, including 43 cases of mandibular ascending branch of malignant tumors, 9 cases of parotid malignant tumor recurrence (adenoid cystic carcinoma in 4 cases), ear and temporal skin cancer recurrence in 3 cases, condylar osteoma and osteochondral Tumor in 10 cases, nerve-derived tumors in 5 cases, up to the foramen ovale to the styloid process within the lateral slope of 114 cases, of which 60 cases of schwannoma, meningioma in 9 cases, 12 cases of sarcoma, poorly differentiated carcinoma in 4 cases, neck Arterial tumor in 16 cases (referring to some cases of reaching the skull base), 13 cases of parotid gland tumor; 8 cases near the foramen magnum, including 2 cases of meningioma, 3 cases of meningioma and 3 cases of schwannoma. CONCLUSIONS: In tumors that can approach or destroy the skull base tissues, the origin of the tumor tissue is different and the areas prone to develop are also different. Therefore, according to the tumor area, you can initially determine the source of tumor tissue, diagnosis and differential diagnosis is helpful, at the same time can help to choose a more reasonable surgical approach.