頭蓋底手術を行った嗅神経芽細胞腫の1例

A Case of Olfactory Neuroblastoma Resected by Skull Base Surgery

I．はじめに

　嗅神経芽細胞腫は，鼻腔に発生する嗅粘膜上皮由来の比較的稀な腫瘍である。近年本疾患に対し，頭蓋底手術による良好な結果が報告がされている^1,2）。しかし，頭蓋内操作を伴うため重篤な合併症や不幸な転帰をたどる危険性もある^3）。

　今回われわれは，前頭葉に進展した嗅神経芽細胞腫に対して頭蓋底手術を行い，様々な術後合併症を認めたが根治し得た症例を経験した。症例の問題点，術後合併症，対策を中心に報告する。

　In recent years,favorable outcomes have been obtained by introducing the skull base surgery to an olfactory neuroblastoma（ONB）. We reported a patient with ONB extending anterior cranial base who underwent a skull base surgery. After total removal of the tumor,the skull base was reconstructed with a pericranial flap and a mesh titanium plate. After the operation,60 Gy radiation was enforced. During and after the course of post-operative irradiation,the MRSA infection in a nasal cavity,meningitis,pneumocephalus and brain abscess had occurred. The problems and treatment of post-operative complications were discussed.