Anterior skull base tumor
Introduction
Introduction of nasal anterior skull base tumor In the malignant tumors of the nasal cavity and sinus, the cancer is more than sarcoma, and the squamous cell carcinoma is the first in clinical practice, accounting for 70%-80%, which occurs in the maxillary sinus. Adenocarcinoma and adenoid cystic carcinoma are second, and occur in the ethmoid sinus. Sarcoma accounts for 10%-20% of nasal and sinus malignant tumors, occurring in the nasal cavity and maxillary sinus, and other sinuses are rare. Sarcoma is the most common malignant lymphoma, more than 60%. There are many types of skull base tumors, tumors occur in the skull base and its adjacent structures, and some tumors can develop from intracranial to extracranial or from extracranial to intracranial. Tumors can grow through the skull base or in the skull after destroying the skull base. According to experts, skull base tumors are usually treated with surgery. The location and characteristics of early diagnosis of tumors are of great significance for the diagnosis and treatment of skull base tumors. Invasion of skull base bone and sinus cancer of the hard brain, the traditional simple transsphenoidal resection of the tumor method, difficult to radical resection, so the long-term efficacy is poor. basic knowledge The proportion of illness: 0.001% Susceptible people: no specific population Mode of infection: non-infectious Complications: cerebrospinal fluid rhinorrhea
Cause
Cause of nasal anterior skull base tumor
Cause:
There are many types of skull base tumors, tumors occur in the skull base and its adjacent structures, and some tumors can develop from intracranial to extracranial or from extracranial to intracranial. Tumors can grow through the skull base or in the skull after destroying the skull base. According to experts, skull base tumors are usually treated with surgery. The location and characteristics of early diagnosis of tumors are of great significance for the diagnosis and treatment of skull base tumors.
Prevention
Prenasal skull base tumor prevention
Points to note for postoperative care of skull base tumors:
1. Pay close attention to possible complications:
a. Patients with anterior cranial fossa tumors may experience olfactory loss and cerebrospinal fluid rhinorrhea after resection.
b. Patients with cavernous sinus tumor may have symptoms of numbness, abduction nerve and other paralysis after surgery.
c. Cerebellar pons and jugular vein area tumor patients may have trigeminal nerve, facial nerve, auditory nerve damage after resection, dysphagia, cough and other symptoms of the cranial nerve.
d. Symptoms of typical respiratory dysfunction may occur after surgery on the slope and occipital macropore.
Experts reminded that for the complications that have already occurred, we must take targeted treatment methods, strengthen nursing measures, and apply active treatment such as neurotrophic drugs.
2. Patients with skull base tumors were re-extracted from the tracheal intubation when cough reflex was found after the surgery was completely awake. If the symptoms of the posterior cranial nerve dysfunction are obvious, tracheotomy should be actively performed. If the breathing is found to be irregular, the tidal volume is insufficient to apply the ventilator to assist the patient in breathing.
3, for tracheotomy patients try to block the tube, should be carried out in the patient's consciousness, breathing is stable and cough reflex is obvious, body temperature is normal. If there is no abnormality after the tube is blocked one day, the tube can be removed. Regardless of whether there is a tracheotomy, as long as the patient is more or more thick, he should take inhalation, and turn over the back to help with drainage. These measures are taken to ensure the patient's airway is unobstructed.
4, postoperative care of skull base tumors should pay attention to, 3 days after surgery, patients routinely fasted water. The first time you eat, the water should be tested by the competent doctor. Patients who have not had significant relief after 3 to 7 days should be placed on the stomach tube for a nasal feeding diet.
5. At the time of discharge, the attending physician should clear the precautions for discharge to the patient and his family, and review the magnetic resonance imaging for 3 months.
Complication
Prenasal skull base tumor complications Complications Cerebrospinal fluid rhinorrhea
The anterior cranial fossa tumor may have olfactory loss and cerebrospinal fluid rhinorrhea.
Symptom
Symptoms of nasal anterior skull base tumor Common symptoms Osteopathic refractory headache Visual impairment Eye muscle paralysis
Clinical manifestations are diverse, can be manifested as intractable headache, exophthalmos, progressive vision loss and ophthalmoplegia.
Examine
Examination of nasal anterior skull base tumor
Invasion of skull base or dura mater, whether benign or malignant, early diagnosis has certain difficulties. Histopathological examination of the primary site has been confirmed to be a malignant tumor, such as rapid development of symptoms, accompanied by intractable headache, exophthalmos, progressive vision loss and ophthalmoplegia, early CT scan or magnetic resonance imaging an examination. Angiography or digital subtraction angiography can play a good role in the localization of vascular-rich tumors and can show its scope of invasion.
Diagnosis
Diagnosis and identification of nasal anterior skull base tumor
diagnosis
Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.
Differential diagnosis
1. Pituitary tumor: pituitary tumor pituitary tumor is a tumor that occurs in the pituitary gland, usually called pituitary adenoma, is one of the common neuroendocrine tumors, accounting for about 10%-15% of central nervous system tumors. The vast majority of pituitary adenomas are benign tumors. Pituitary tumors usually occur in young adults and often affect the patient's growth and development, fertility, learning and work ability.
2. Craniopharyngioma: A craniopharyngioma originates from the squamous epithelial cells that remain in the pituitary embryogenesis. It is a common congenital intracranial benign tumor in the category of skull base tumors, mostly located on the saddle. A few are in the saddle. There are many different names for craniopharyngioma, which are related to the initial site and growth, such as saddle cyst, cranial buccal tumor, pituitary tube tumor, ameloblastoma, epithelial cyst, enamel and so on. The onset of craniopharyngioma is mostly in children and adolescents. Its main clinical features are hypothalamic-pituitary dysfunction, increased intracranial pressure, visual and visual impairment, diabetes insipidus, and neurological and psychiatric symptoms.
3. Saddle nodule meningioma: Saddle nodule meningioma includes meningioma originating from saddle nodules, anterior cleft, saddle septum, and sphenoidal platform. The cause of saddle nodule meningioma is unclear. Some people think that it is related to internal environmental changes and genetic variation, but it is not caused by a single factor. Craniocerebral trauma, radiation exposure, viral infection, etc., which may cause chromosomal mutation or cell division speed may be related to the occurrence of meningioma.
4. Cavernous sinus tumor: The tumor in the cavernous sinus area is mostly meningioma, but the meningioma that is actually originated in the cavernous sinus is rare, mostly caused by the invasion of adjacent parts, such as sphenoid bone, saddle nodule, Rock bones, slopes, etc., usually cavernous sinus meningioma refers to the tumor has invaded the internal structure of the cavernous sinus.
