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目的探讨切除前中颅底、额、筛窦、眶沟通性肿瘤的最佳手术方式,以满足临床需要。方法对13例前中颅底颅鼻眶沟通瘤患者采用额眶筛入路、T型切口,将外鼻下翻,切除部分筛窦、纸板、额骨眶部及额窦后壁,充分暴露肿瘤组织,在手术显微镜下分块或完全切除肿瘤,分离、保护相应解剖部位,如视神经、内动脉、蝶鞍和脑膜等重要解剖结构。将外鼻回复,用钛板钛钉与额骨固定,恢复良好颌面外形。结果13例颅鼻眶沟通瘤手术均获得成功,随访24个月,11例肿瘤无复发,均无脑脊液鼻漏、脑膜脑膨出等并发症。面部外形良好。结论经额眶筛进入、侧下翻鼻骨入路是耳鼻咽喉科切除前中颅底颅鼻眶沟通瘤的一种良好方法。
Objective To explore the best surgical approach to remove the anterior skull base, frontal, ethmoid, orbital communicating tumors to meet the clinical needs. Methods Thirteen patients with cranial nasion orbital tumor before cranio-cranial skull base were treated with frontal orbital sieve approach, T-incision, partial nasopharyngeal distension, part of ethmoid sinus, cardboard, frontal orbital and frontal sinus posterior wall. Tumor tissue, under the microscope under the microscope or complete removal of the tumor, separation, protection of the corresponding anatomical sites, such as the optic nerve, internal arteries, sella and meninges and other important anatomical structures. The outer nasal return, titanium plate with titanium screws and fixed to restore a good shape of the maxillofacial. Results Thirteen cases of cranio-nasal orbital tumor were successful. All cases were followed up for 24 months. No recurrence was found in 11 cases. No complications such as cerebrospinal fluid rhinorrhea and encephalocele were found. Facial shape is good. Conclusions The approach of nasolabial orbital mesioma through the orbital orbital screen and the approach of the nasal orbital nasal orbital nasal fossa before the otorhinolaryngology resection is a good method.