Se presenta el abordaje quirúrgico de la translocación facial ampliada, empleado en tres enfermos con tumores extensos de la base craneal. En dos de los enfermos se consiguió una resección macroscópicamente completa. En el tercer enfermo la reducción tumoral permitió emplear con mayor efectividad la radioterapia externa. La técnica de la translocación facial combinada con otras vías de abordaje anterolaterales a la base del cráneo proporciona un campo quirúrgico excelente. El parénquima cerebral no es retraído durante la resección y las estructuras neurovasculares son manipuladas bajo un control directo. La distancia quirúrgica al tumor se reduce al máximo, pudiendo éste ser disecado desde distintas direcciones. Los principales problemas relacionados con este abordaje son, la obturación de los grandes defectos postquirúrgicos y la obtención de resultados estético-funcionales adecuados.
We are presenting our experience with the extended facial translocation in the surgical treatment of three patients with extensive cranial base tumors. In two cases we achieved complete tumor resection and in the third case the mass of the neoplasm (a pituitary adenoma) was largely reduced facilitating external radiation therapy.
This surgical approach combined with anterolateral approaches to the cranial base provides an excellent surgical field for the resection of large cranial base tumors under direct control, avoiding brain retraction and manipulation of neurovascular structures. The distance to tumor boundaries is much reduced and dissection can be performed from different directions. The main problem related with this technique is the filling of the large postsurgical dead spaces and obtaining satisfactory aesthetic results.
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