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首页> 外文期刊>Neurocirugia >Abordaje subcraneal: Consideraciones técnicas y aplicaciones en patología traumática craneofacial
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Abordaje subcraneal: Consideraciones técnicas y aplicaciones en patología traumática craneofacial

机译：颅下入路：创伤性颅面病理学的技术考虑和应用

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Introduction. Suitable approach to anterior cranial base is mandatory to get global satisfactory surgical out-comes. In the beginning it depends on the exactly anatomical position into the cranial fossa and tridimensional spread. Surgical approach implies the evaluation of the patient status, reconstructive options and surgical team experience. Subcranial approach is a safe surgical option in the treatment of frontal traumatic pathology. It allows adequate management of frontal sinus and its obliteration with easy radiologic follow-up. Objectives. To analyse subcranial approach as a treatment option in traumatic pathology of the anterior cranial base and to present our review of subcranial approach. Valuation of surgical technical aspects. and related complications. Material and methods. Retrospective analysis of 50 patients operated (subcranial approach) from January 2004 to December 2009 by Maxillofacial and Neurosurgery Department, University Hospital 12 de Octubre, Madrid. 34 patients presented craniofacial trauma or postraumatic sequela and 16 patients presented craniofacial tumours. Oncological cases offers experience to discuss surgical aspects. Results are related to traumatic pathology and sequela. Main items review were surgical technique including materials used for frontal sinus obliteration, associated traumatic pathology, hospital stay and complication rates. Results. No perioperatory mortality was found. Patients' age ranged 15-76 years. 22 were male and 12 female. Description of frontal fractures involved. Frontal sinus obliteration was made with calvarian bone dust. Morbidity rates was 29% in posttraumatic patients. Mean hospital stay was 13 days. Conclusions. Subcranial approach to anterior cranial base is a safe and reliable treatment option to the pathology of this area. It allows outstanding exposure of the nasal cavity, orbits, ethmoidal cells-sphenoid sinus and great access to anterior fossa without frontal lobe retraction.
机译：介绍。为了获得整体满意的手术结果，必须对前颅底采取合适的方法。在开始时，它取决于进入颅窝的确切解剖位置和三维扩散。手术方法意味着对患者状态，重建方案和手术团队经验的评估。颅底入路是治疗额骨外伤性病理的安全手术选择。通过简便的放射学随访，可以对额窦及其闭塞进行适当的处​​理。目标。分析颅前入路作为前颅底外伤病理的一种治疗选择，并介绍我们的颅下入路。评估手术技术方面。及相关并发症。材料与方法。回顾性分析2004年1月至2009年12月在马德里de Octubre的大学医院上颌面和神经外科部门手术治疗的50例患者（颅后入路）。 34例出现颅面创伤或术后遗留后遗症，16例出现颅面肿瘤。肿瘤病例提供了讨论外科方面的经验。结果与创伤性病理和后遗症有关。综述的主要内容是外科手术技术，包括用于额窦闭塞的材料，相关的创伤性病理，住院时间和并发症发生率。结果。未发现围手术期死亡率。患者年龄为15-76岁。男性22位，女性12位。涉及额骨骨折的描述。用颅骨粉尘封闭额窦。创伤后患者的发病率为29％。平均住院时间为13天。结论。颅前入路颅底入路是该区域病理学的一种安全可靠的治疗选择。它可以使鼻腔，眼眶，筛窦细胞，蝶窦显着暴露，并且可以轻松进入前窝，而无需额叶缩回。

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