山东大学耳鼻喉眼学报 ›› 2015, Vol. 29 ›› Issue (4): 51-54.doi: 10.6040/j.issn.1673-3770.0.2015.112

• 论著 • 上一篇    下一篇

内镜翼突入路治疗中颅底良性占位性病变

郑朝攀, 周敬淳, 韩灵, 张搏, 马玲国   

  1. 深圳市人民医院耳鼻咽喉科, 广东 深圳 518000
  • 收稿日期:2015-03-10 修回日期:2015-06-12 出版日期:2015-08-16 发布日期:2015-08-16
  • 通讯作者: 马玲国。E-mail:ljymax@163.com E-mail:ljymax@163.com
  • 作者简介:郑朝攀。E-mail:450739097@qq.com

The management of benign space-occupying lesion of the middle skull base via the endoscopic pterygopalatine space approaches.

ZHENG Chaopan, ZHOU Jingchun, HAN Ling, ZHANG Bo, MA Lingguo   

  1. Department of Otolaryngology, Shenzhen People's Hospital, Shenzhen 518000, Guangdong, China
  • Received:2015-03-10 Revised:2015-06-12 Online:2015-08-16 Published:2015-08-16

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摘要： 目的 探讨鼻内镜下翼突入路切除中颅底病变的适应证和手术方法。方法 回顾分析深圳市人民医院耳鼻咽喉科2011年5月至2014年12月收治的9例经鼻内镜翼突入路手术切除中颅底良性病变的临床资料, 其中神经鞘瘤3例, 蝶旁囊肿2例, 肉芽肿性血管炎1例, 炎性假瘤1例, 纤维血管瘤1例, 骨纤维异常增殖综合征1例。随访4~36个月。结果 9例均成功手术切除, 随访期内无复发。5例术后上颌神经分布区域出现麻木感, 3例出现鼻腔干燥症状, 随后逐渐减轻。患者术后均无脑脊液鼻漏、脑膜炎等症状。结论 经鼻内镜翼突入路手术切除颅底占位性病变能够达到微创手术切除良性肿瘤的要求。

关键词: 颅底, 占位性病变, 鼻内镜外科手术, 翼突入路

Abstract: Objective To discuss the surgical technique and indications of benign space-occupying lesion of the middle skull base via the endoscopic pterygopalatine space approaches. Methods Nine patients with benign space-occupying lesions of the middle skull base operated via the endoscopic pterygopalatine space approaches from May 2011 to December 2014 were retrospectively analyzed. The lesions included 3 schwannoma, 2 parasphenoide sinus cyst, 1 granulomatous vasculitis, 1 inflammatory pseudotumor, 1 fibroangioma and 1 fibrous dysplasia. Results The lesions were all removed. No recurrence happened during a 17-month follow- up on the average. There was no occurrence of cerebrospinal fluid rhinorrhea or meningitis in all patients. Five patients had obvious numbness in the maxillary nerve innervation area and 3 patients had mycteroxerosis after the operation, but these symptoms disappeared afterwards. Conclusion The management of benign space-occupying lesion of the middle skull base via the endoscopic pterygopalatine space approaches was reliable with minimal invasion and total removal of some benign lesions.

Key words: Endoscopic surgical procedures, operative, Skull base, Space-occupying lesion, Pterygopalatine space approaches

中图分类号: 

  • R765.9
[1] 张秋航, 杨大章, 韩军.内镜经鼻翼腭窝肿瘤切除术[J]. 中国微侵袭神经外科杂志, 2006,11(10):441-442. ZHANG Qiuhang, YANG Dazhang, HAN Jun. Establishment of concept on endoscopic nasal skull base surgery[J]. Chin J Minim Invas Neurosurg, 2006, 11(10):441-442.
[2] Taniguchi M, Kohmura E. Endoscopic transnasal transmax- illary transpterygoid approach to the parapharyngeal space: an anatomic study[J]. Minim Invasive Neurosurg, 2010, 53(5-6):255-60.
[3] 张秋航. 内镜经鼻颅底外科理念的建立[J]. 中国微侵袭神经外科杂志,2006,11(10):433-434. ZHANG Qiuhang. Establishment of concept on endoscopic nasal skull base surgery[J]. Chin J Minim Invas Neurosurg, 2006, 11(10):433-434.
[4] de Lara D, Ditzel Filho L F, Prevedello D M, et al. Endonasal endoscopic approaches to the paramedian skull base[J]. World Neurosurg, 2014, 82(6S):S121-129.
[5] 周兵,黄谦,崔顺九,等. 内镜下经鼻泪前隐窝入路切除翼腭窝及颞下窝神经鞘瘤[J]. 中华耳鼻咽喉头颈外科杂志, 2013,48(10):802-806. ZHOU Bin, HUANG Qian, CUI Shunjiu, et al. Removal of Schwannoma in the pterygopalatine and infratemperal fossa via endoscopic prelacrimal recess approach[J]. Chin J Otorhinolaryngol Head Neck Surg, 2013, 48(10):802-806.
[6] Ciporen J N, Moe K S, Ramanathan D, et al. Multiportal endoscopic approaches to the central skull base: a cadaveric study[J]. World Neurosurg, 2010, 73(6):705-712.
[7] Shin M, Kondo K, Saito N. Neuroendoscopic transnasal surgery for skull base tumors: basic approaches, avoidance of pitfalls, and recent innovations[J]. Neurol Med Chir (Tokyo), 2012, 52(10):697-703.
[8] 徐睿,张秋航,左可军,等. 经鼻内镜蝶窦进路岩尖胆脂瘤切除[J]. 中华耳鼻咽喉头颈外科杂志, 2012,47(1):30-33. XU Rui, ZHANG Qiuhang, ZUO Kejun, et al. Resection of petrous apex cholesteatoma via endoscopic trans-sphenoidal approach[J]. Chin J Otorhinolaryngol Head Neck Surg, 2012, 47(1):30-33.
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