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目的探讨侵犯到颅内及海绵窦的鼻咽血管纤维瘤的外科治疗。方法病例包括1988年1月至2004年1月收治的经病理证实的侵犯到颅内的鼻咽血管纤维瘤16例,11～35岁。手术方法有经口腭入路、鼻侧切开入路、上颌骨中段掀翻、颅面联合进路、下颌正中裂开联合经腭入路和上颌骨翻转入路。结果伴颅内侵犯鼻咽血管纤维瘤16例患者共行手术28次,11例为复发病变。28例次手术中11例次鼻侧切开术,颅面联合进路6例次,额颞入路2例次,经腭入路4例次,经上颌骨入路2例次,经下颌正中裂开1例次,上颌骨中段掀翻2例次。结论扩展到颅内或海绵窦的鼻咽血管纤维瘤治疗以手术彻底切除为主,上颌骨中段掀翻、颅面联合进路及经下颌正中裂开颅底进路对于侵犯到颅内或海绵窦的肿瘤暴露较好。
Objective To investigate the surgical treatment of nasopharyngeal angiofibroma infringed into intracranial and cavernous sinus. Methods From January 1988 to January 2004 admitted to the method of pathologically confirmed intracranial nasopharyngeal angiofibroma 16 cases, 11 to 35 years old. Surgical methods include oral palate approach, nasal open approach, midmaxal overturned, craniofacial joint approach, the mandibular median cleft palate and the maxillary approach. Results 16 patients with intracranial invasion of nasopharyngeal angiofibroma were operated 28 times in total, 11 cases were recurrent lesions. In 28 cases, 11 cases underwent nasal resection, craniofacial approach 6 cases, frontotemporal approach 2 cases, palatal approach 4 cases, maxillary approach 2 cases and mandibular approach In the middle of 1 case of split, maxillofacial overturned in 2 cases. Conclusions The treatment of nasopharyngeal angiofibroma extended to the intracranial or cavernous sinus is mainly based on radical resection. The middle maxilla overturns, the craniofacial approach, Sinus cancer is well exposed.