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        "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Se analizan la presentaci&#243;n cl&#237;nica y radiol&#243;gica&#44; los procedimientos quir&#250;rgicos empleados&#44; los resultados y la evoluci&#243;n a largo plazo en 90 pacientes operados de meningioma del ala esfenoidal entre 1976 y 1997&#44; periodo durante el cual se incorporaron cambios en los m&#233;todos de diagn&#243;stico por imagen y la t&#233;cnica quir&#250;rgica&#46;</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">La edad media de presentaci&#243;n fue de 50&#46;3 a&#241;os y un 62&#46;2&#37; de los pacientes eran mujeres&#46; La duraci&#243;n media de los s&#237;ntomas fue de 3&#46;1 a&#241;os&#46; Se lograron resecciones completas en 61 casos &#40;extirpaciones grados de Simpson I-II&#41; en la primera intervenci&#243;n&#46; La mortalidad perioperatoria fue del 4&#46;4&#37;&#46; El tiempo medio de seguimiento fue de 8&#46;3 a&#241;os&#46; Veinticinco pacientes mostraron&#44; bien recurrencia de un tumor supuestamente extirpado de manera radical&#44; o bien crecimiento adicional de un tumor extirpado subtotalmente&#44; pero s&#243;lo 12 fueron reoperados&#44; en tanto que otros con un crecimiento tumoral lento est&#225;n siendo observados&#46; Dos pacientes fallecieron a raiz de la reintervenci&#243;n y 4 m&#225;s por progresividad de tumores en masa&#46; Otros 9 pacientes &#40;con o sin recurrencia&#41; murieron por causas no relacionadas durante el periodo de observaci&#243;n&#46;</p><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se comentan las posibilidades de resecci&#243;n radical en funci&#243;n de la edad del paciente y la presentaci&#243;n anatomocl&#237;nica&#44; el valor de la TAC y la RM en el seguimiento y detecci&#243;n de la recurrencia y la utilidad de las nuevas t&#233;cnicas de abordaje a la base craneal y de la radioterapia convencional o estereot&#225;xica en el control de estos tumores&#46;</p>"
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        "resumen" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">The authors analyze the clinicoradiological presentation&#44; the surgical results and the postoperative courses in 90 patients operated for sphenoid ridge meningioma between 1976 and 1997&#46;</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">The mean age of the patients was 50&#46;3 years and 62&#46;2&#37; of the patients were females&#46; Average duration of symptoms was 3&#46;1 years&#46; Complete tumor removal &#40;Simpsom grades I and 11&#41; was&#183; achieved in 61 cases at initial operation&#46; Perioperative mortality was 4&#46;4&#37;&#46; The mean follow-up period was 8&#46;3 years&#46; Twenty five patients showed either recurrence or progressive tumor grow but only 12 underwent reoperation&#46; Two patients died following reoperation and 4 more because of tumor progression&#46; Nine more patients &#40;with or without recurrence&#41; died from unrelated causes during the follow-up&#46; Most of non reoperated patients with recurrent or residual tumor show slow tumor progression and are under observation&#46;</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">The possibilities for radical resection at initial operation&#44; the value of computerized tomography and magnetic resonance for the follow-up&#44; and the usefulness of new surgical approaches to the skull base and postoperative radiotherapy&#44; either conventional or stereotatic&#44; in tumor control are commented&#46;</p>"
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        "nota" => "<p class="elsevierStyleNotepara">Lobato&#44; R&#46;D&#46;&#59; Alday&#44; R&#46;&#59; G&#243;mez&#44; P&#46;A&#46;&#59; Ayerbe&#44; J&#46;&#59; S&#225;nchez Aniceto&#44; G&#46;&#59; Ramos&#44; A&#46;&#59; S&#225;nchez Turanzas&#44; F&#46;&#59; Rivero&#44; B&#46;&#59; Rodr&#237;guez&#44; C&#46;&#58; Meningiomas del ala esfenoidal&#46; Estudio de 90 casos&#46; Neurocirug&#237;a 1999&#59; 10&#58; 13&#8211;26&#46;</p>"
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Vol. 10. Issue 1.
Pages 13-26 (January 1999)
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Vol. 10. Issue 1.
Pages 13-26 (January 1999)
Meningiomas del ala esfenoidal. Estudio de 90 casos
Sphenoid Wing Meningiomas. Analysis of 90 cases
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R.D. Lobato, R. Alday, P.A. Gómez, J. Ayerbe, G. Sánchez Aniceto, A. Ramos, P. González, B. Rivero, C. Rodríguez
Servicios de Neurocirugía y Cirugía Maxilofacial y Sección de Neurorradiología Hospital Universitario «12 de Octubre». Universidad Complutense. Madrid
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Resumen

Se analizan la presentación clínica y radiológica, los procedimientos quirúrgicos empleados, los resultados y la evolución a largo plazo en 90 pacientes operados de meningioma del ala esfenoidal entre 1976 y 1997, periodo durante el cual se incorporaron cambios en los métodos de diagnóstico por imagen y la técnica quirúrgica.

La edad media de presentación fue de 50.3 años y un 62.2% de los pacientes eran mujeres. La duración media de los síntomas fue de 3.1 años. Se lograron resecciones completas en 61 casos (extirpaciones grados de Simpson I-II) en la primera intervención. La mortalidad perioperatoria fue del 4.4%. El tiempo medio de seguimiento fue de 8.3 años. Veinticinco pacientes mostraron, bien recurrencia de un tumor supuestamente extirpado de manera radical, o bien crecimiento adicional de un tumor extirpado subtotalmente, pero sólo 12 fueron reoperados, en tanto que otros con un crecimiento tumoral lento están siendo observados. Dos pacientes fallecieron a raiz de la reintervención y 4 más por progresividad de tumores en masa. Otros 9 pacientes (con o sin recurrencia) murieron por causas no relacionadas durante el periodo de observación.

Se comentan las posibilidades de resección radical en función de la edad del paciente y la presentación anatomoclínica, el valor de la TAC y la RM en el seguimiento y detección de la recurrencia y la utilidad de las nuevas técnicas de abordaje a la base craneal y de la radioterapia convencional o estereotáxica en el control de estos tumores.

Palabras Clave:
Meningioma
Edema cerebral
Tomografía computerizada
Resonancia magnética
Abstract

The authors analyze the clinicoradiological presentation, the surgical results and the postoperative courses in 90 patients operated for sphenoid ridge meningioma between 1976 and 1997.

The mean age of the patients was 50.3 years and 62.2% of the patients were females. Average duration of symptoms was 3.1 years. Complete tumor removal (Simpsom grades I and 11) was· achieved in 61 cases at initial operation. Perioperative mortality was 4.4%. The mean follow-up period was 8.3 years. Twenty five patients showed either recurrence or progressive tumor grow but only 12 underwent reoperation. Two patients died following reoperation and 4 more because of tumor progression. Nine more patients (with or without recurrence) died from unrelated causes during the follow-up. Most of non reoperated patients with recurrent or residual tumor show slow tumor progression and are under observation.

The possibilities for radical resection at initial operation, the value of computerized tomography and magnetic resonance for the follow-up, and the usefulness of new surgical approaches to the skull base and postoperative radiotherapy, either conventional or stereotatic, in tumor control are commented.

Key Words:
Meningioma
Brain edema
Computerized tomography
Magnetic resonance

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