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目的 介绍治疗广泛性鼻咽血管纤维瘤的成败经验,以资借鉴。方法 回顾12例广泛性鼻咽血管纤维瘤的处理。主要采用面中部掀翻、上颌窦径路或辅以其他切口和径路切除肿瘤。结果12例中10例均能全切肿瘤。2例向颅内扩展,均因术中出血凶猛未能全切。结论 合理的切口和径路,可以获得较宽阔的术野、能直视下切除肿瘤。肿瘤如侵入颅内,累及视神经、海绵窦、斜坡或破裂孔等处,则不易彻底切除。术前经DSA栓塞供瘤血管可减少术中出血。
Objective To introduce the successful experience of treatment of extensive nasopharyngeal angiofibroma in order to draw lessons. Methods 12 cases of extensive nasopharyngeal angiofibroma were retrospectively reviewed. The main use of mid-face overturned, maxillary sinus path or supplemented by other incision and pathology to remove the tumor. Results of 12 cases in 10 cases were able to cut the tumor. 2 cases of intracranial expansion, both due to intraoperative bleeding fierce failed to cut. Conclusion Reasonable incision and path, you can get a wider field of surgery, the tumor can be removed under direct vision. Tumors such as invasive in the skull, involving the optic nerve, cavernous sinus, slopes or ruptured holes, etc., is not easy to completely removed. Preoperative DSA embolization for tumor blood vessels can reduce intraoperative bleeding.