RESUMEN
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.
Asunto(s)
Anestesia/métodos , Monitoreo Intraoperatorio/métodos , Procedimientos Neuroquirúrgicos/métodos , Cuidados Preoperatorios/métodos , Neoplasias de la Base del Cráneo/cirugía , Base del Cráneo , Adolescente , Adulto , Anciano , Anestésicos/administración & dosificación , Anestésicos/efectos adversos , Humanos , Persona de Mediana Edad , Evaluación de Resultado en la Atención de Salud , Flujo Sanguíneo Regional , Base del Cráneo/irrigación sanguínea , Base del Cráneo/patología , Base del Cráneo/cirugía , Neoplasias de la Base del Cráneo/metabolismo , Neoplasias de la Base del Cráneo/patología , Equilibrio HidroelectrolíticoRESUMEN
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.
Asunto(s)
Venas Cerebrales/cirugía , Seno Sagital Superior/cirugía , Adulto , Anciano , Anastomosis Quirúrgica/métodos , Neoplasias Encefálicas/irrigación sanguínea , Neoplasias Encefálicas/diagnóstico por imagen , Neoplasias Encefálicas/cirugía , Angiografía Cerebral/métodos , Venas Cerebrales/diagnóstico por imagen , Femenino , Humanos , Masculino , Persona de Mediana Edad , Seno Sagital Superior/diagnóstico por imagen , Tomografía Computarizada Espiral/métodos , UltrasonografíaRESUMEN
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.
Asunto(s)
Fosa Craneal Media , Fosa Craneal Posterior , Neoplasias Nasales/cirugía , Procedimientos Quirúrgicos Orales/métodos , Neoplasias de los Senos Paranasales/cirugía , Neoplasias de la Base del Cráneo/patología , Adulto , Anciano , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Invasividad Neoplásica , Neoplasias Nasales/diagnóstico por imagen , Neoplasias Nasales/patología , Neoplasias de los Senos Paranasales/diagnóstico por imagen , Neoplasias de los Senos Paranasales/patología , Estudios Retrospectivos , Neoplasias de la Base del Cráneo/diagnóstico por imagen , Neoplasias de la Base del Cráneo/cirugía , Tomografía Computarizada por Rayos XRESUMEN
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.
