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目的:为了完整大块切除中耳侧颅底区巨大肿瘤以及同期修复巨大术腔,探索良好术野。方法:外耳翻揭酌情采用两种术式(1)耳颈联合“Y”形切口,将耳廓向上翻揭,便于处理腮腺、颈上深淋巴结;(2)耳内外联合倒“U”形切口,将耳廓向下翻转,便于处理上鼓室乳突天盖、颅中窝底区病变。结果:15例病人术中视野暴露充分,肿瘤均能一次大块完整切除,并同期用邻近自体带蒂肌瓣修补颅底,术后伤口一期愈合。3年存活率80%(12/15)、巳随访5年者占46.6%(7/15)。结论:采用外耳翻揭径路,术中视野暴露充分,既便于完整大块切除肿瘤,又便于同期修补侧颅底,术后并发症少,也便于尽早补充放射治疗。
OBJECTIVE: In order to complete a large block resection of large tumors in the skull base area of the middle ear and to repair a huge surgical cavity at the same time, to explore a good operative field. METHODS: Two types of surgical procedures were used to correct the parotid gland and cervical deep lymph nodes. (2) U "-shaped incision, the ear down flip, easy to handle on the tympanic mastoid cover, cranial fossa in the bottom of the lesion. Results: All the 15 patients were well exposed in the field of vision. All the tumors could be completely resected in one large block, and the skull base was repaired with the adjacent autologous pedicle flap during the same period. The wounds healed in one time. Three-year survival rate was 80% (12/15), followed by 5 years accounted for 46.6% (7/15). Conclusions: The method of external ear turning over and exposure, full exposure in the field of vision, which not only facilitates the complete mass resection of the tumor, but also facilitates the repair of the skull base at the same time with less postoperative complications and also facilitates the early radiotherapy.