The application of radiofrequency ablation in the resection of lateral skull base tumor through an endoscopic endonasal approach
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摘要: 目的：探讨低温等离子射频消融技术在内镜侧颅底肿瘤切除术中应用的安全性和可行性，并初步评价其治疗效果。方法：对12例侧颅底肿瘤患者采用等离子射频辅助内镜经鼻或经口入路完成肿瘤切除手术。并对所采用的手术技术要点、肿瘤切除程度、术后并发症及治疗效果等进行总结。结果：本组患者的术中出血量60~500 ml，中位数为190 ml；手术时间60~180 min，中位数为95 min。全部颅底肿瘤均获得了彻底切除，无新增的脑神经功能障碍出现，无脑脊液鼻漏及颅内感染等并发症，有1例出现了术后颈内动脉夹层动脉瘤，经介入治疗痊愈出院。随访28~30个月，无肿瘤复发及与本肿瘤相关的死亡。结论：低温等离子射频辅助下的内镜入路侧颅底肿瘤切除术可以较为安全、可靠地切除经过选择的侧颅底肿瘤。Abstract: Objective: To summarize our experience of resecting tumors in lateral skull base via a radiofrequency ablation-assisted endoscopic approach to investigate the safety and feasibility of the technique and to assess its treatment outcomes.Method: Twelve patients with lateral skull base tumor were operated through a radiofrequency ablation-assisted endoscopic transnasal or transoral approach. In this study, the operative technique was described,and the degree of resection, complications and the clinical outcomes was analyzed.Result: Complete resection was achieved in all patients using this technique. No patient in the series experienced a new neurological deficit, cerebrospinal fluid leak or meningitis after surgery. One patient suffered from dissecting aneurysm on 4th day after operation. And the dissecting aneurysm were treated by vascular interventional therapy. No recurrence and death related skull base tumor in the follow-up period(28-30 months) were found. The volume of intraoperative blood loss was from 60 ml to 500 ml(medium 190 ml). The duration of operations was from 60 min to 180 min(medium 95 min).Conclusion: Our limited experience indicates that this technique is feasible and safe for the complete resection of some skull base tumors in selected cases.
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