Endoscopic nasal and anterior craniotomy resection for malignant nasoethmoid tumors involving the anterior skull base
Endoscopic nasal and anterior craniotomy resection for malignant nasoethmoid tumors involving the anterior skull base
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DOI：
10.1055/s-2005-922095
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发表时间：
2006-02-01
影响因子：
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通讯作者：
Tomei, Giustino
中科院分区：
文献类型：
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作者：
Castelnuovo, Paolo G.;Belli, Evaristo;Tomei, Giustino
目的：鼻窦肿瘤累及颅底的传统手术入路是前颅面切除术。Ketcham等人的第一份报告（American Journal of Surgery，1963;106：698-703）记录了他们对17例鼻鼻窦恶性肿瘤行前颅面切除术的经验。后来在几个中心使用该技术的经验导致发表了许多技术改进，并进一步降低了与该手术相关的发病率和死亡率。在我们的手中，内窥镜技术使我们能够接近颅底病变的鼻内方面，而无需外部切口，但仍然实现了整体切除。本文讨论了适用于这种方法的病变类型和相关的技术问题。方法：1999年至2004年，18例恶性鼻筛窦肿瘤患者接受了鼻内镜下和前颅切开切除术。患者平均年龄60.2岁，男女比例为15比3。平均随访时间为25.1个月。结果：2例死于术后并发症，3例死于复发，2例死于无关原因。11例患者无疾病，平均生存期为19.8个月。结论：虽然我们不认为这种方法可以取代传统的前颅面切除术，但它是颅底外科医生的一个重要辅助手段。
Objectives: The traditional approach to sinonasal tumors involving the skull base has been the anterior craniofacial resection. The first report by Ketcham et al (American Journal of Surgery, 1963;106:698-703) documented their experience with 17 anterior craniofacial resections for malignant tumors of the sinonasal tract. Later experience with this technique at several centers has resulted in the publication of many refinements of technique and further reduction in the morbidity and mortality associated with this procedure. In our hands, endoscopic techniques have allowed us to approach the intranasal aspect of skull base lesions without external incisions and yet still achieve an en bloc resection. The type of lesions suitable for this approach and the associated technical issues are discussed in this article. Methods: Between 1999 and 2004, 18 patients with malignant nasoethmoid tumors underwent endoscopic nasal and anterior craniotomy resections. The average age of the patients 60.2 years, with a male-to-female distribution of 15 to 3. Mean follow-up period was 25.1 months. Results: Two patients died from postoperative complications, three died from recurrent disease and two from unrelated causes. Eleven patients are free of disease with a mean survival of 19.8 months. Conclusions: Although we do not consider this approach a replacement for the traditional anterior craniofacial resection, it is an important adjunct in the skull base surgeon's armamentarium.