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目的 :探讨治疗颅底近颅底肿瘤的最佳手术入路。方法 :对 16 1例颅底近颅底肿瘤 ,采用颅面联合入路 6例 ,上颌骨截除或 (和 )眶内容物摘除术 5例 ,鼻侧切开术 7例 ,额眶入路 1例 ,上颌骨切开外旋及扩大外旋入路 2 1例 ,经颈合并下颌骨切开外旋入路 30例 ,经颈入路 4 8例 ,耳后大C形切口入路 19例 ,颈腮入路 8例 ,经口入路 6例 ,颞额入路 8例 ,耳前颞下入路 2例。结果 :98例良性肿瘤中除 2例经口入路者复发外 ,余无复发。恶性肿瘤 6 3例 ,1例术后 1.5个月并发脑脊液漏死于颅内感染。生存期最长 1例已超过 8年。生存 5年以上 10例 ,3年以上 19例 ,2年以上 16例 ,1年以上 16例。 3、5年生存率分别为 5 9.18% (2 9/49) ,38.4 6 % (10 /2 6 )。结论 :只有根据颅底肿瘤的具体部位及范围、病理类型进行术式设计 ,选择合适的手术入路才能提高颅底肿瘤的治疗效果。
Objective: To explore the best surgical approach for the treatment of skull base near skull base tumor. Methods: One hundred and sixteen cases of cranial base skull base tumors were treated with craniofacial approach in 6 cases, maxillary excision or orbital content excision in 5 cases, nasal lateral incision in 7 cases, frontal orbital approach One case was excised maxillofacial circumcision and enlarged circumflex 21 cases. Thirty cases underwent maxillary incision and external maxillary incision were treated by cervical approach. Forty-eight cases underwent transcranial approach and 19 posterior major C-cut approach Cases, cervical cheek approach in 8 cases, 6 cases of oral approach, the temporal frontal approach in 8 cases, 2 cases of anterior inferior temporal infratemporal approach. Results: In 98 cases of benign tumors in addition to two cases of oral re-entry, I no recurrence. Sixty-three cases of malignant tumors, one case of 1.5 months after the cerebrospinal fluid leakage in intracranial infection. The longest survival period of more than 8 years. Survival of more than 5 years in 10 cases, 3 years in 19 cases, more than 2 years in 16 cases, more than 1 year in 16 cases. The 3-year and 5-year survival rates were 5 9.18% (29/49) and 38.4% (10/2 6), respectively. Conclusion: Only based on the specific location of the skull base tumor and the scope of the pathological type of surgical design, select the appropriate surgical approach to improve the treatment of skull base tumors.