论文部分内容阅读
目的 探讨鼻窦骨化纤维瘤的手术进路 ,分析各种手术的方法和特点。方法 回顾性分析我院 1994年 8月～ 2 0 0 1年 7月治疗的鼻窦骨化纤维瘤 35例的临床资料。结果 35例中男 2 3例 ,女 12例 ,年龄 2～ 4 5岁 ,平均 17 1岁。手术方式包括鼻侧切开手术、鼻内镜下手术、冠状切口颅骨切开手术 (包括冠状切口颅骨切开联合鼻内镜下手术及冠状切口颅骨切开联合鼻侧切开手术 )、Caldwell Luc进路手术。鼻内镜下手术 2 2例 ,彻底切除 8例 ,部分切除 14例。 2例在影像导航辅助下手术。鼻侧切开手术 6例 ,彻底切除 4例 ,部分切除 2例。冠状切口颅骨切开手术 5例 ,彻底切除 2例 ,部分切除 3例 ,有 2例联合鼻内镜下手术 ,1例联合鼻侧切开手术。Caldwell Luc进路手术 2例 ,均为部分切除。 35例患者随访 33例 ,失访 2例 ,平均随访时间 3 5年。结果 14例无复发 ,14例带瘤生存 ,5例复发后再次手术。结论 鼻窦骨化纤维瘤手术进路的选择主要依据病变范围 ,同时要考虑器官结构的功能、美容、手术的难易程度以及术者的经验和习惯等。
Objective To explore the surgical approach of ossifying fibroses of the sinuses and to analyze the methods and characteristics of various operations. Methods The clinical data of 35 cases of ossified fibroses of sinuses were retrospectively analyzed in our hospital from August 1994 to July 2001. Results 35 cases of male 23 cases, 12 females, aged 2 to 45 years, mean 17 1 years. Surgical methods include nasal incision surgery, endoscopic sinus surgery, coronal incision cranial incision (including coronal incision and endoscopic surgery and endoscopic cranial incision combined with nasal open surgery), Caldwell Luc Approach surgery. Endoscopic surgery 22 cases, complete resection in 8 cases, partial resection in 14 cases. 2 cases under the guidance of video navigation surgery. 6 cases of nasal incision, complete resection in 4 cases, partial resection in 2 cases. Coronal incision in 5 cases of skull incision, radical resection in 2 cases, partial resection in 3 cases, 2 cases of combined endoscopic surgery, 1 case of combined nasal incision surgery. Caldwell Luc approach surgery in 2 cases, all partial resection. Thirty-five patients were followed up in 33 cases, 2 cases were lost to follow-up, with an average follow-up time of 35 years. Results 14 cases without recurrence, 14 cases with tumor survival, 5 cases re-operation after recurrence. Conclusion The selection of surgical approach for sinonosclerosis is mainly based on the extent of the lesion. At the same time, we should consider the function of the organ structure, the beauty, the ease of operation and the experience and habits of the surgeon.