[1]陈峰,高下,覃道芬,等.鼻内镜治疗颅底疾病112例报告[J].中国微创外科杂志,2008,08(2):101-103.
　Chen Feng,Gao Xia,Qin Daofen,et al.Endoscopic Endonasal Surgery for Skull Base Lesions: Report of 112 Cases[J].Chinese Journal of Minimally Invasive Surgery,2008,08(2):101-103.
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鼻内镜治疗颅底疾病112例报告()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
08
期数:
2008年2期
页码:
101-103
栏目:
出版日期:
2008-10-24

文章信息/Info

Title:
Endoscopic Endonasal Surgery for Skull Base Lesions: Report of 112 Cases
作者:
陈峰; 高下; 覃道芬; 戴艳红; 陈杰; 俞晨杰
南京大学医学院附属鼓楼医院耳鼻咽喉-头颈外科，南京210008
Author(s):
Chen Feng;  Gao Xia;  Qin Daofen;  et al.
Department of Otorhinolaryngology, DrumTower Hospital, Nanjing University Medical School, Nanjing 210008, China
关键词:
颅底; 内镜; 耳鼻喉外科手术
Keywords:
Skull base; Endoscopy; Otorhinolaryngological surgery
分类号:
R765.9;R651.1
文献标志码:
A
摘要:
目的探讨鼻内镜径路治疗颅底疾病的价值。方法2002年5月~2006年12月，对112例颅底疾病行鼻内镜径路手术，其中脑脊液鼻漏39例，垂体瘤4例，脑膜膨出或脑膜脑膨出3例，蝶筛囊肿9例，蝶窦炎伴息肉2例，真菌性蝶窦炎12例，内翻性乳头状瘤11例，鼻咽纤维血管瘤6例，骨化纤维瘤2例，骨纤维异常增殖2例，脊索瘤7例，颅咽管瘤2例，鳞癌10例，未分化癌1例，乳头状瘤癌变2例。 结果全组均在鼻内镜下处理，其中20例病变为次全切除，包括鳞癌8例、未分化癌1例、脊索瘤7例、颅咽管瘤2例、骨纤维异常增殖2例。脑脊液鼻漏1次手术成功31例（79.5%），2次成功4例，3次成功4例，最终成功率100%。1例脑膜脑膨出术后2个月复发并伴脑脊液漏，内镜下再次手术成功。1例内翻性乳头状瘤术后11个月复发，改行鼻侧切开术。1例真菌性蝶窦炎术后4个月复发行再次内镜手术。1例脑脊液鼻漏术后颅内感染。结论鼻内镜径路可以处理多种颅底疾病，是一种安全、有效、微创的手术方式，但仍需严格掌握手术适应证，特别是恶性肿瘤。
Abstract:
ObjectiveTo evaluate the value of endoscopic endonasal approach in the surgical treatment of skull base lesions. MethodsFrom May 2002 to December 2006, 112 patients with skull base lesions were treated by endoscopic endonasal surgery. Among them, 39 cases had cerebrospinal fluid (CSF) leak, 4 pituitary adenoma, 3 meningoencephalocele, 9 sphenoethmoidal cyst, 2 sphenoiditis complicated with ploypi, 12 fungal sphenoiditis, 11 inverted papilloma, 6 nasopharyngeal fibroangioma, 2 ossifying fibroma, 2 fibrous dysplasia, 7 chordoma, 2 craniopharyngioma, 10 squamous cell carcinoma, 1 undifferentiated carcinoma, and 2 papillomatous change.ResultsFollowup ranged from 6 to 60 months. All the operations were completed under an endoscope. In 20 cases including 8 patients with squamous cell carcinoma, 1 undifferentiated carcinoma, 7 chordoma, 2 craniopharyngioma, and 2 fibrous dysplasia, the lesion was removed subtotally. In the 39 patients with CSF leak, the lesion was cured after the first operation in 31 patients (79.5%), after the second operation in 4, and the third in 4; the final success rate was 100%. One of the patients with meningoencephalocele showed recurrence complicated CSF leakage 2 months after the operation, and then was cured by reoperation using endoscopy. In the 11 patients with inverted papilloma, 1 had recurrence 11 months after the operation, and was retreated by lateral rhinotomy. One of the patients who had fungal sphenoiditis developed recurrence 4 month after the operation and received endoscopic endonasal surgery for the second time. One patient who had CSF leak before the operation developed intracranial infections after the endoscopic surgery.ConclusionEndoscopic endonasal surgery is a safe, effective, and minimally invasive approach to treat skull base lesions. Clinicians should understand the operation indications precisely, especially for malignant tumors.

参考文献/References:

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备注/Memo

备注/Memo:
高下通讯作者
更新日期/Last Update: 2013-10-22