Neurosurgical interventions on the skull base including craniofacial block-resections were fulfilled on 36 patients aged from 16 through 73 years. Preoperative management of the patients was made mainly at the intensive therapy room. It included correction of water-electrolyte, protein metabolism, anemia. The key moments in the anesthetic management of such operations were maintenance of an adequate level of neurovegetative blockade, sufficient level of volemia by means of creating hypervolemic hemodilution, prophylactics of air embolism.
Anesthesia/methods , Monitoring, Intraoperative/methods , Neurosurgical Procedures/methods , Preoperative Care/methods , Skull Base Neoplasms/surgery , Skull Base , Adolescent , Adult , Aged , Anesthetics/administration & dosage , Anesthetics/adverse effects , Humans , Middle Aged , Outcome Assessment, Health Care , Regional Blood Flow , Skull Base/blood supply , Skull Base/pathology , Skull Base/surgery , Skull Base Neoplasms/metabolism , Skull Base Neoplasms/pathology , Water-Electrolyte Balance
The authors demonstrated alternative ways of bloodflow from occluded superior sagittal sinus through hypertrophic dural veins (middle meningeal veins) and sphenoparietal sinus. Parameters of bloodflow were evaluated using triplex ultrasonography. The possibility of venous drainage into anterior segment of superior sagittal sinus proximal to the site of occlusion with further retrograde flow towards dural venous anastomosis is verified. Possibilities of spiral CT-venography and standard time-of-flight MR-venography for assessment of collateral venous flow were estimated.
Cerebral Veins/surgery , Superior Sagittal Sinus/surgery , Adult , Aged , Anastomosis, Surgical/methods , Brain Neoplasms/blood supply , Brain Neoplasms/diagnostic imaging , Brain Neoplasms/surgery , Cerebral Angiography/methods , Cerebral Veins/diagnostic imaging , Female , Humans , Male , Middle Aged , Superior Sagittal Sinus/diagnostic imaging , Tomography, Spiral Computed/methods , Ultrasonography
An analysis of combined treatment of 11 patients with tumors of the paranasal sinuses involving the skull base was made. Radical surgical interventions were performed in the volume of nasal exenteration, maxillectomy and orbital exenteration, nasal exenteration, and total maxillectomy. The technique of surgical interventions and results of treatment are described.
Cranial Fossa, Middle , Cranial Fossa, Posterior , Nose Neoplasms/surgery , Oral Surgical Procedures/methods , Paranasal Sinus Neoplasms/surgery , Skull Base Neoplasms/pathology , Adult , Aged , Female , Follow-Up Studies , Humans , Male , Middle Aged , Neoplasm Invasiveness , Nose Neoplasms/diagnostic imaging , Nose Neoplasms/pathology , Paranasal Sinus Neoplasms/diagnostic imaging , Paranasal Sinus Neoplasms/pathology , Retrospective Studies , Skull Base Neoplasms/diagnostic imaging , Skull Base Neoplasms/surgery , Tomography, X-Ray Computed
Treatment of 3 patients with malignant tumors of the skull base using transfacial accesses as half maxilotomy by the Kosson access and access with osteotomy of a nasoorbital complex was analyzed that provided a possibility to ablate large and gigantic tumors of the localization in question using the operative microscope and a traditional instruments' kit.
Cranial Fossa, Posterior , Skull Base Neoplasms/surgery , Surgery, Oral/methods , Follow-Up Studies , Humans , Magnetic Resonance Imaging , Male , Middle Aged , Osteotomy/methods , Retrospective Studies , Skull Base Neoplasms/diagnosis
