- 期刊
Approach for Midline Skull Base Tumor Using Le Fort I-Palatal Split Osteotomy: Extent and Problems
勒佛一式骨切開術合併顎切開術於顱底中線腫瘤切除之應用
摘要
顱底病灶需要安全且足夠的手術途徑才能夠成功切除，在顱底中線蝶骨斜坡周圍是傳統手術途徑難以有效治療的地方。在應用勒佛一式骨切開術合併顎切開術後，這方面的手術得到了很大的進展。雖然這類的手術途徑已經有數位作者發表了相關文獻，可是卻缺乏手術結果以及併發症的文獻報告。我們從1990年到2006年共進行了21次手術治療了18位病人。病灶成因、手術結果、併發症以及其處置都被回顧並給予討論。
關鍵字
無資料並列摘要
Successful treatment of skull base lesions depends on the ability to gain adequate exposure with safe operative procedure. An area of the skull base that has historically posed as obstacles to operative exposure is the midline region centered on the clivus. Significant developments in the surgical approach occurred when Le Fort I-palatal split procedure was introduced. The purpose of this study was to evaluate the complications, effectiveness and outcomes of Le Fort I-palatal split approach. From 1990 to 2006, 18 patients received 21 Le Fort I osteotomy approaches for skull base tumor at our Craniofacial Center in Chang Gung Memorial Hospital. The average age of operation was 39 years old, ranging from 28 to 58 years old. The clinical follow-up ranged from eleven month to 7 years, with an average of 3.4 years. The clinical outcomes and complications were retrospectively studied. The lesions were miscellaneous, and more than half were chordoma. Three patients with chordoma underwent a repeated operation using the same procedure. The locations of lesions ranged from clivus down to C2 level. There was no death or major neurological deficit related to the approach. The post operative complications included 1 case of meningitis, 2 malocclusions, 1 velopharyngeal insufficiency and 2 soft palate dehiscences. No problem with mouth opening or viability of bone or tooth was noted. In conclusion, the Le Fort I-palatal split technique is a safe and effective approach. It provides exposure for midline skull base lesions from clivus down to C2 level. The complications were relatively minor and could be successfully treated.
延伸閱讀
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