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目的探讨沟通性鼻腔肿瘤临床特点和治疗方法。方法 75例患者均行术前CT检查定位诊断。颅鼻沟通性性肿瘤63例,其中内翻性乳头状瘤恶变8例,神经胶质瘤14例,低分化癌15例,嗅母细胞瘤17例,胚胎性横纹肌肉瘤9例。口鼻沟通性肿瘤12例,其中硬腭混合瘤9例,乳头状瘤3例。63例采用颅面联合进路,12例采用Weber-Fergusson进路。结果 75例患者肿瘤全切56例,次全切除12例,部分切除7例,无术中死亡病例。63恶性沟通性肿瘤随访57例,术后1年存活55例,术后2年存活46例,术后3年38例。结论沟通性鼻腔肿瘤分别采用颅面联合联合进路、Weber-Fergusson进路,可充分显露肿瘤,采用带蒂额肌帽状腱膜裂层颅骨瓣修复颅底缺损,效果满意,值得临床推广。
Objective To investigate the clinical features and treatment of communicating nasal tumor. Methods 75 patients underwent preoperative CT examination of the diagnosis. 63 cases of craniofacial malignant tumors, including 8 cases of inverted papilloma malignant, glioma in 14 cases, poorly differentiated carcinoma in 15 cases, 17 cases of olfactory blastoma, embryonal rhabdomyosarcoma in 9 cases. Nasal and nasal tumors in 12 cases, including 9 cases of mixed palate tumors, papilloma in 3 cases. 63 cases with craniofacial approach, 12 cases using Weber-Fergusson approach. Results Totally 56 patients underwent resection of the tumor in 75 patients, 12 underwent subtotal resection and 7 underwent partial resection without any intraoperative death. Fifty-seven patients with malignant tumor were followed up, 55 patients survived one year after operation, 46 patients survived two years after operation, and 38 patients achieved three years after operation. Conclusion The nasal neoplasms with craniofacial combined approach and Weber-Fergusson approach, respectively, can fully reveal the tumor. The skull flap with pedicle-capped aponeurosis is used to repair the skull base defect with satisfactory results, which is worthy of clinical promotion.