RESUMO
The paper analyzes application of orbitozygomatic approaches at the Department of Skull Base and Craniofacial Surgery of the Burdenko Neurosurgical Institute for a 14-year period. During this time, 723 patients were operated on using the orbitozygomatic approach, which has become the workhorse of surgery for skull base tumors spreading into the orbit, paranasal sinuses, and pterygopalatine and infratemporal fossae. The authors describe seven major modifications of the orbitozygomatic approach that they have used in their practice.
Assuntos
Craniotomia/métodos , Neoplasias Nasais/cirurgia , Neoplasias Orbitárias/cirurgia , Fossa Pterigopalatina/cirurgia , Neoplasias da Base do Crânio/cirurgia , Osso Temporal/cirurgia , Humanos , Invasividade Neoplásica , Neoplasias Nasais/patologia , Neoplasias Orbitárias/patologia , Fossa Pterigopalatina/patologia , Neoplasias da Base do Crânio/patologia , Osso Temporal/patologia , Resultado do TratamentoRESUMO
The paper is written in the lecture format and dedicated to one of the main basal approaches, the orbitozygomatic approach, that has been widely used by neurosurgeons for several decades. The authors describe the historical background of the approach development and the surgical technique features and also analyze the published data about application of the orbitozygomatic approach in surgery for skull base tumors and cerebral aneurysms.
Assuntos
Aneurisma Intracraniano/cirurgia , Procedimentos Neurocirúrgicos/métodos , Neoplasias da Base do Crânio/cirurgia , Base do Crânio/cirurgia , HumanosRESUMO
The results of surgical and combination therapy of 302 patients with benign tumors of the anterior and middle regions of the skull base with allowance for the functional outcomes (immediately after surgery and during the catamnestic follow-up) are reported. The Karnofsky and Rankin scales and the Anterior Skull Base Questionnaire (ASBQ) were used for the analysis. Radical tumor resection, as compared to partial resection, reduces the quality of life in the early postoperative period but increases it in future; the use of radiation therapy in combination treatment for patients with radically inoperable tumors does not worsen their quality of life in the late postoperative period.
Assuntos
Neoplasias Meníngeas/cirurgia , Meningioma/cirurgia , Qualidade de Vida , Neoplasias da Base do Crânio/cirurgia , Atividades Cotidianas , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Humanos , Avaliação de Estado de Karnofsky , Masculino , Neoplasias Meníngeas/patologia , Meningioma/patologia , Pessoa de Meia-Idade , Testes Neuropsicológicos , Qualidade de Vida/psicologia , Neoplasias da Base do Crânio/patologia , Inquéritos e Questionários , Adulto JovemRESUMO
AIM: To identify the most frequently occurring symptoms resulting from the affection of internal and external skull base in patients with benign tumors of the anterior and middle cranial base. MATERIAL AND METHODS: The authors analyzed a complex of history, clinical, and instrumental data as well as results of combined treatment of 642 patients with benign tumors of the anterior and middle cranial base operated Medical Research between 2007 and 2011. RESULTS: Neurological signs and symptoms in patients with benign tumors of the anterior cranial base, parasellar region, and middle cranial fossa were studied. In the majority of cases, the tumor extended extracranially. The most common groups of symptoms were identified and described, the most important groups are presented in the diagrams. The proposed scheme is applicable also for malignant tumors or other mass lesions of the same localization. CONCLUSION: Effective treatment and selection of the best management of a patient depends on modern medical approaches and techniques including neuroimaging. Careful assessment of symptoms is crucial in detection of tumors in the early stage. Dynamic monitoring of the patient using the proposed scheme will contribute to early detection of tumor recurrence or progression.