Background:
In this paper, we report a clinical series of skull base lesions operated on trough the MiniPT, extending its application to skull base lesions, either using the classical minipterional or a variant, we call extradural minipterional approach (MiniPTEx).
Methods:
We describe our surgical technique of operating on complex skull base lesions using a minipterional extradural approach. Anterior clinoidectomy, middle fossa peeling, transcavernous, and Kawase approaches were performed as needed. In total, we carried out 24 surgeries: three skull base tumors, 1 Moyamoya case, and 20 giant/complex intracranial aneurysms. All the patients present good neurological result (mRs < 3). Only two patients had paralysis of any cranial nerve and only one patient had a mild hemiparesis.
Results:
This surgery series there are 24 cases, 10 patients were treated with exclusive MiniPT. MiniPT extradural approach was made in 14 patients. Twelve were treated using pure MiniPTEx approach, 1 patient using transcavernous approach, and in 1 patient, the anterior clinoid was resected with the combination of a MiniPT, a medium fossa peeling, and the Kawase anterior petrosectomy for skull base surgery.
Conclusion:
We further advance the indications of the MiniPT by extending it to operate on the cranial base tumors or complex vascular lesions without additional morbidity. MiniPT approach may be safely associated with skull base techniques, including anterior and posterior clinoidectomies, peeling of the middle fossa, transcavernous approach, and anterior petrosectomy. The versatility of the MiniPT craniotomy and the feasibility of performing skull base surgery through the MiniPT technique have been demonstrated in this paper.
Introducción: El tratamiento microquirúrgico de los aneurismas cerebrales no rotos, ha demostrado ser seguro en distintas series, la indicación quirúrgica en estos casos es discutible y generalmente esta en relación a su riesgo de sangrado por características morfológicas y ubicación del aneurisma. Este trabajo tiene como objetivo, determinar si en nuestra región, el tratamiento microquirúrgico de los aneurismas cerebrales no rotos es seguro y así poder dar una recomendación de tratamiento a nuestros pacientes.Materiales y métodos: Treinta y un pacientes, 33 aneurismas cerebrales no rotos fueron tratados, En clínica Elqui y Hospital San Pablo de la Región de Coquimbo, entre mayo del 2017 y marzo del 2019, se hizo un seguimiento al total de los pacientes y se evaluó su resultado neurológico según la escala de Rankin modificado.Resultado: 97% de los pacientes obtuvieron un resultado neurológico favorable (Rankin < 3), solo un 3% de los pacientes, un caso, obtuvo un resultado desfavorable (Rankin > 2).Conclusión: El tratamiento microquirúrgico de los aneurismas cerebrales no rotos en nuestra región es seguro, obteniendo una muy baja morbilidad y 0% de mortalidad.
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