Tratamiento neuroquirúrgico de los neurinomas del acústico sin indicación de tratamiento con radiocirugía
Neurosurgical treatmentof acoustic neuromas without indication for radiosurgery
J.M. González-Darder
, J.V. Pesudo-Martínez, R. Feliu-Tatay, J.M. Borrás-Moreno
Servicio de Neurocirugía. Hospital General de Castellón. Castellón de la Plana
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"apellidos" => "González-Darder" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "J.V." "apellidos" => "Pesudo-Martínez" ] 2 => array:2 [ "nombre" => "R." "apellidos" => "Feliu-Tatay" ] 3 => array:2 [ "nombre" => "J.M." "apellidos" => "Borrás-Moreno" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Neurocirugía. Hospital General de Castellón. Castellón de la Plana" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Correspondencia postal: Servicio de Neurocirugía. Hospital General de Castellón. 12003 Castellón de la Plana." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Neurosurgical treatmentof acoustic neuromas without indication for radiosurgery" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2003-12-18" "fechaAceptado" => "2004-02-03" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec158537" "palabras" => array:3 [ 0 => "Neurinoma del acústico" 1 => "Nervio facial" 2 => "Abordaje suboccipital" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec158538" "palabras" => array:3 [ 0 => "Acustic neuroma" 1 => "Facial nerve" 2 => "Suboccipital approach" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">El propósito de este trabajo es revisar la problemática de los neurinomas del acústico mayores de 8cc de volumen o 2,5cm de diámetro máximo en el ángulo pontocerebeloso, que no son susceptibles de tratamiento con radiocirugía. Se han incluido un total de 18 lesiones, con un volumen medio de 27.4cc, lo que equivale a una lesión de unos 3,8cm en sus tres diámetros. El seguimiento medio es de 48.7 meses. No hubo mortalidad. En todos los casos se consiguió la exéresis completa de la lesión sin recidivas, con conservación anatómica del nervio facial en el 66.7% de los casos y recuperación funcional (grados I-II de House-Brackmann) en el 27.8%, ninguno con grado I. Como secuelas definitivas, en todos los pacientes hubo cófosis, en dos casos hipostesia trigeminal con anestesia corneal y en un caso afectación cerebelosa. Se concluye señalando que la morbilidad de la exéresis de los neurinomas del acústico de gran tamaño es muy alta, es especial la afectación del nervio facial, por lo que es necesario diseñar estrategias especialmente dirigidas a minimizarlas.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The aim of this paper is to review the specific problems of the microsurgical management of the acoustic neuromas not suitable for radiosurgical treatment, that is measuring more than 8cc in volume or 2,5cm in máximum diameter in the cerebelopontine angle. A total of 18 lesions have been included with a mean volume of 27.4cc, representing a lesion measuring 3,8cm in its theee main diameters. The mean follow-up has been 48.7 months. There has been no mortality. All lesions were competely excised without recurrences. The ana-tomic conservation of the facial nerve was achieved in the 66.7% of the cases but the functional recovery (House-Brackmann grades I-II) was reached only in the 27.8%, without any grade I case. As permanent deficit all patients had postoperative cophosis, two had trigeminal hyposthesia with corneal anesthesia and one had a cerebellar deficit. The main conclussion is that the microsurgical radical resection of large acoustic neuromas not suitable for radiosurgical treatment is followed by a high postoperative morbidity mainly related with the facial nerve lesion. Therefore, it seems rationale to design specific strategies directed to reduce and alleviate these permanent deficits.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">González-Darder, J.M.; Pesudo-Martínez, J.V.; Feliu-Tatay, R.; Borras-Moreno, J.A.: Tratamiento neuroquirúrgico de los neurinomas del acústico sin indicación de tratamiento con radiocirugía. Neurocirugía 2004; 15: 439–446.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:27 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Surgical excision of acoustic neuroma: patient outcome and provider caseload" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "F.G. Barker" 1 => "B.S. Carter" 2 => "R.G. Ojemann" 3 => "R.W. Jyung" 4 => "D.S. Poe" 5 => "M.J. 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| año/Mes | Html | Total | |
|---|---|---|---|
| 2023 Marzo | 2 | 0 | 2 |
| 2018 Febrero | 10 | 9 | 19 |
| 2018 Enero | 18 | 19 | 37 |
| 2017 Diciembre | 12 | 25 | 37 |
| 2017 Noviembre | 42 | 41 | 83 |
| 2017 Octubre | 12 | 27 | 39 |
| 2017 Septiembre | 11 | 25 | 36 |
| 2017 Agosto | 12 | 49 | 61 |
| 2017 Julio | 15 | 52 | 67 |
| 2017 Junio | 21 | 52 | 73 |
| 2017 Mayo | 25 | 35 | 60 |
| 2017 Abril | 15 | 51 | 66 |
| 2017 Marzo | 10 | 71 | 81 |
| 2017 Febrero | 10 | 62 | 72 |
| 2017 Enero | 9 | 38 | 47 |
| 2016 Diciembre | 23 | 36 | 59 |
| 2016 Noviembre | 18 | 58 | 76 |
| 2016 Octubre | 24 | 45 | 69 |
| 2016 Septiembre | 59 | 107 | 166 |
| 2016 Agosto | 69 | 57 | 126 |
| 2016 Julio | 35 | 31 | 66 |
| 2016 Mayo | 2 | 0 | 2 |
| 2016 Abril | 1 | 0 | 1 |
| 2016 Marzo | 6 | 0 | 6 |
| 2016 Febrero | 3 | 0 | 3 |
| 2015 Diciembre | 2 | 0 | 2 |
| 2015 Agosto | 1 | 0 | 1 |
| 2015 Julio | 1 | 0 | 1 |
| 2015 Junio | 18 | 45 | 63 |
| 2015 Mayo | 18 | 58 | 76 |
| 2015 Abril | 15 | 47 | 62 |
| 2015 Marzo | 16 | 58 | 74 |
| 2015 Febrero | 9 | 70 | 79 |
| 2015 Enero | 8 | 37 | 45 |
| 2014 Diciembre | 16 | 37 | 53 |
| 2014 Noviembre | 12 | 51 | 63 |
| 2014 Octubre | 17 | 92 | 109 |
| 2014 Septiembre | 18 | 71 | 89 |
| 2014 Agosto | 15 | 63 | 78 |
| 2014 Julio | 11 | 65 | 76 |
| 2014 Junio | 18 | 84 | 102 |
| 2014 Mayo | 21 | 75 | 96 |
| 2014 Abril | 11 | 80 | 91 |
| 2014 Marzo | 12 | 80 | 92 |
| 2014 Febrero | 22 | 80 | 102 |
| 2014 Enero | 14 | 65 | 79 |
| 2013 Diciembre | 14 | 44 | 58 |
| 2013 Noviembre | 13 | 43 | 56 |
| 2013 Octubre | 23 | 75 | 98 |
| 2013 Septiembre | 13 | 60 | 73 |
| 2013 Agosto | 24 | 43 | 67 |
| 2013 Julio | 34 | 47 | 81 |
| 2013 Junio | 19 | 59 | 78 |
| 2013 Mayo | 8 | 74 | 82 |
| 2013 Abril | 13 | 81 | 94 |
| 2013 Marzo | 14 | 49 | 63 |
| 2013 Febrero | 12 | 43 | 55 |
| 2013 Enero | 13 | 32 | 45 |
| 2012 Diciembre | 14 | 39 | 53 |
| 2012 Noviembre | 0 | 24 | 24 |
| 2012 Octubre | 0 | 6 | 6 |
| 2012 Septiembre | 0 | 2 | 2 |
| 2012 Enero | 15 | 0 | 15 |
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