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目的 完整切除侵及前颅底区肿瘤 ,提高治愈率。方法 采用颅 -面联合径路 ,其中单用带血管蒂帽状腱膜 -颅骨膜瓣 4例 ,帽状腱膜 -颅骨膜瓣加肋骨片或钛网板各2例修补颅底。 8例未做颅底重建。结果 肿瘤全切 16例 ,无 1例手术死亡、长期脑脊液漏或 /和颅内感染 ,5例恶性肿瘤患者术后存活 3~ 5年 ;3例存活 1~ 2年 ;均未见肿瘤复发。另4例在 2年内分别死于局部复发和远处转移 ,4例良性肿瘤患者术后随诊 1~ 7年未见复发。结论 颅 -面联合径路前颅底区肿瘤切除术 ,具有术野大、显露清楚、安全可靠 ,有利于肿瘤整块切除。硬脑膜修补和颅底重建 ,可有效地防止脑脊液漏和颅内感染等并发症
Objective To complete resection of tumors in the anterior skull base and improve the cure rate. Methods Cranio-facial joint approach was used, in which 4 cases were treated with vascular pedicled aponeurosis and cranial periosteum flaps, and the skull base was repaired with cap-like diaphragm-cranial perforation plus ribs or titanium mesh. Eight cases did not have skull base reconstruction. Results There were 16 cases of complete tumor resection, no case of surgical death, long-term cerebrospinal fluid leakage or/and intracranial infection, 5 cases of malignant tumor patients survived for 3 to 5 years after operation, 3 cases survived for 1 to 2 years, and no tumor recurrence was found. The other 4 patients died of local recurrence and distant metastasis within 2 years, and 4 patients with benign tumor had no recurrence 1 to 7 years after follow-up. Conclusion The anterior skull base tumor resection of the cranio-maxillary combined approach has a large operative field, is clear, safe, and reliable, and is beneficial to tumor resection. Dural repair and skull base reconstruction can effectively prevent complications such as cerebrospinal fluid leakage and intracranial infection