전두개저를 침범한 종양의 두개안면절제술후 합병증과 그 결과
Complications and Outcome of Craniofacial Resection for Anterior Skull Base Tumors
소속 상세정보
이상형/Sang Hyung Lee
이동엽/양희진/오창완/진태훈/정영섭1정희원1조병규/Dong Yeob Lee/Hee Jin Yang/Chang Wan Oh/Tae Hoon Jinn/Young Seob Chung/Hee Won Jung/Byung Kyu Cho
KMID : 0359819990280010082
Abstract
결론
두개안면절제술은 전두개저의 해부학적 지식의 발전으로 광범위한 부위의 효과적인 노출
이 가능하고, 두개저 복원수술방법의 발달로 비강 또는 부비동과 전두개저의 종양에 대한
일차적인 치료로서 안전하게 이용될 수 있는 방법이다. 이 방법을 이용하여 수술한 증례를
통해서 본 결과 악성종양의 경우에는 뇌수막이나 뇌실질의 침범 유무 및 안구로의 침윤이
생존에 영향을 미치는 것으로 사료되었다.
The purpose of this study is to evaluate the complications of anterior craniofacial
resection for the neoplasms of invading the anterior cranial base and the effectiveness of
anterior craniofacial resection on local control and survival.
We analyzed clinical experience of 19 patients with anterior skull base lesions
retrospectively, who underwent anterior craniofacial resection between January 1991 and
November 1997 at the Department of Neurosurgery joining with Otolaryngology.
Seventeen cases were malignant tumor. The spectrum of disease included
esthesioneuroblastoma(7 patients), squamous cell carcinoma(4 patients), malignant
teratoma(2 patients), and others were malignant melanoma, undifferented cell carcinoma,
osteogenic sarcoma. Ewing's sarcoma. Two patients had ossifying fibroma. There was
no operative mortality. The complications occurred in 11 cases(58％). Patients with
complications included six cases of infection, two with CSF leak. Others were transient
impairment of mental status, pneumocephalus and transient diplopia. In six cases with
infection, two case of osteomyelitis were managed by surgical removal of infected bone
flap, the others were controlled conservatively without any sequelae.
The overall survival rate for malignant tumor at 14 months is 53％. There was a
trend to decreased survival time in regard of tumor invasion to the bone, the dura, and
the parenchyme. Presence of orbital invasion showed significant influence on survival
time.
Anterior craniofacial resection is a relatively safe procedure for surgical management
of tumors involving the anterior skull base with or without intracranial invasion.
키워드
Anterior craniofacial resection; tumors; Complication; Survival;
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