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作者自1975年以来,采用经面部进路或与颅前窝联合进路术式,保留上颌骨表面-眶上-筛骨骨膜瓣,切除侵犯颅底或鼻咽部、颞下窝,蝶窦、筛窦及口咽部巨大肿瘤。本文报导19例:鼻咽纤维瘤16例:筛-额粘液囊肿1例,鼻部神经胶质细胞瘤1例,筛窦腺瘤1例。手术方法:(1)切口:鼻测切开直到鼻小柱向下延及人中至上唇皮肤-粘膜缘切开,暴露两侧鼻前庭及前磨牙牙槽突。(2)暴露并细心剥离面部骨膜瓣:对上颌骨表面、鼻腔外侧壁及眶上等处行骨膜下剥离,并保留好骨膜瓣。切断眶下神经、血管,以便在上颌骨表面获得更大的骨膜瓣。游离泪道管至关重
Since 1975, the authors have adopted facial approach or combined with anterior cranial fossa surgery to preserve the maxillary surface - supraorbital - ethmoidal periosteal flap, and to encroach on the skull base or nasopharynx, infratemporal fossa, sphenoid sinus , Ethmoid sinus and oropharyngeal huge tumor. This article reports 19 cases: 16 cases of nasopharyngeal fibroma: screen - frontal mucocele in 1 case, nasal glioblastoma in 1 case, 1 case of ethmoid sinus adenoma. Surgical methods: (1) incision: nasal open until the columella extending down to the upper lip skin - mucosal margin incision, exposing both sides of the nasal vestibule and premolar alveolar process. (2) expose and carefully peel off the facial periosteal flap: subperiosteal stripping of the maxillary surface, lateral nasal wall and supraorbital, and keep the periosteal flap. Cut off the infraorbital nerve and blood vessels in order to obtain a larger periosteal flap on the maxillary surface. Free lacrimal duct tube is crucial