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Transpalatal-transpharyngeal Approach for the Treatment of Tumors in the Midline Area of Skull Base: Microsurgical Anatomy and Clinical Application

Author: ChenXiaoLei
Tutor: LiuNing
School: Nanjing Medical University
Course: Neurosurgery
Keywords: Skull base central part Surgery by the way Microsurgical anatomy Tumor Deformity Micrographic surgery
CLC: R651
Type: Master's thesis
Year: 2008
Downloads: 65
Quote: 0
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Abstract


The first part of the oral palatal pharyngeal approach to the treatment of the anatomy of the skull base midline area lesions Objective To study the oral velopharyngeal approach microsurgical anatomy , anatomical reference for the surgery to protect vital structures . Methods 20 cases of the skull dried specimens , observation and measurement of the bone structure ; 15 cases of formalin-fixed cadaver under the microscope simulated surgical approach , microscopic anatomy of the structures involved observed , measured and photographed . Results of oral palatal pharyngeal approach should be taken as the inverted \Wear open the ethmoid wall and sphenoid platform of worn saddle nodules , sphenoid posterior wall , saddleback , the slope and the anterior arch of atlas part of the bone , the longitudinal incision subdural might be revealed in the suprachiasmatic pool , optic nerve , pituitary brainstem structure . Conclusion mouth velopharyngeal approach fully exposed , and are familiar with its microscopic anatomy of the surgical treatment of skull base midline area lesions significance . The second part of oral palatal pharyngeal clinical approach to the treatment of skull base midline area lesions Objective To investigate after the mouth palate ingestion method approach for microsurgical treatment of skull base midline area lesions . Methods palate pharynx into the oral a road treatment of 18 cases of skull base midline region tumor free hard palate , endoscopic sub- block , the entire surgery to remove the tumor , surgery to repair the dura mater , the hard palate bone I reset fixed . Results of 18 cases of chordoma 9 cases , 3 cases of metastatic cancer , two cases of angiofibroma , pituitary adenoma, 2 cases of nasopharyngeal carcinoma patients , pharynx posterior wall of squamous cell carcinoma . All patients exposed to satisfaction , 12 tumors endoscopic subtotal resection , 6 cases subtotal complications including cases of cerebrospinal fluid rhinorrhea one cases of poor articulation , no death , paralysis and other serious complications . This group of patients were followed up for 6 to 30 months , of which three cases respectively after one year , a year and a half , 2 -year local recurrence , metastatic cancer died of lung primary tumor and I are back to normal life . Conclusion mouth velopharyngeal approach has fully exposed , surgical trauma, less complication . This approach is the preferred approach for treating lesions of the skull base midline area .

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CLC: > Medicine, health > Surgery > Of surgery > Head and Neurosurgery
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