颅鼻眶肿瘤手术切除与缺损重建

目的经颅-鼻腔双重入路，Ⅰ期整块切除颅鼻眶肿瘤，应用颅骨外板及帽状腱膜骨膜瓣Ⅰ期修复前颅底巨大缺损。方法本组16例颅鼻眶恶性肿瘤，采用经颅-鼻腔双重入路方法1期整块切除肿瘤。术中行双额冠状瓣开颅、骨瓣形成、经前颅窝底探查肿瘤侵犯部位及程度，Ⅰ期整块切除前颅底及筛窦、眼眶恶性肿瘤。应用鼻腔内窥镜摘除鼻腔内肿瘤。肿瘤切除后，采用颅骨外板、钛板和带蒂帽状腱膜骨膜瓣或双侧颞肌筋膜瓣修复前颅底巨大缺损。结果肿瘤整块切除，术后复发率低。术中Ⅰ期修补巨大缺损，术后无脑脊液漏及脑膨出等并发症发生。结论经颅-鼻腔双重入路Ⅰ期切除颅鼻眶恶性肿瘤，手术入路方便，肿瘤切除彻底。应用颅骨外板、钛板及带蒂帽状腱膜骨膜瓣可Ⅰ期修补肿瘤切除后巨大缺埙，修复效果安全可靠，能有效防止前颅底手术后并发症。

Operative Removal of Cranionasal-orbital Tumors and Reconstruction of the Defect

Objective To remove enbloc cranionasal-orbital tumors, then, reconstruct the large the defect in the anterior skull base with cranial outer table and galea aponeurotica-pericranium flap. Methods Sixteen patients with cranionasal-orbital tumors, underwent enbloc removal of tumors via cranionasal double approach. Results The tumors were en bloc removed, the rate of recurrence is lower, there were no complications such as cerebrospinal fluid leak. Conclusion It is convenient in operative approach and cranionasal-orbital malignant neoplasms via cranionasal double approach en bloc. it is safe and efficial to reconstruct the large the defect in the anterior skull base with cranial outer table and galea aponeurotica-pericranium flap. It can prevent the post-operative complications in anterior skull base.