SINOPSEIntrodução: O acesso transbasal é uma abordagem interessante para o manejo de patologias que acometem a base do crânio anterior, sejam elas intradurais ou extra durais. Estas lesões podem ter localização exclusiva no compartimento intracraniano, bem como estenderem-se aos terços superior e médio da face, tornando este acesso uma alternativa para as lesões craniofaciais.Objetivo: A revisão da utilização do acesso transbasal para o manejo das patologias da base do crânio e craniofaciais, assim como a discussão das vantagens desta via em relação às demais abordagens descritas na literatura. Material e método: Foram comentadas as principais etapas da técnica cirúrgica do acesso transbasal e apresentados três casos clínicos distintos para a ilustração da aplicação da abordagem.Conclusão: Os resultados obtidos com esta via para o tratamento destas lesões são muito satisfatórios, oferecendo ampla possibilidade de acesso, com resultados cosméticos excelentes, evitando incisões na face. A possibilidade de fístula de líquor é a complicação mais comum e que requer especial atenção.Palavras-chave: Abordagem transbasal, tumores da base de crânio, tumores craniofaciais, cirurgia da base de crânio. ABSTRACT Transbasal approach for the management of the skull base and craniofacial pathologies. Report of 3 casesIntroduction: The transbasal approach is interesting to the management of the pathologies of the anterior skull base in the intradural and extradural compartments. Such lesions can also extend to the upper and middle third of the face, becoming the approach an alternative to the treatment of the craniofacial diseases.Objective: To review the application of the transbasal approach to the treatment of the anterior skull base and craniofacial pathologies. The advantages of such approach are also discussed. Material and method:The key steps of the surgical technique are described and three clinical cases are presented with, to illustrate the approach. Conclusion:The results obtained in the management of the lesions located in the craniofacial and anterior skull base are encouraging, with wide exposition of the region and excellent cosmetic results, avoiding facial incisions. CSF leakage is the most frequent complication and it requires special attention. RelatosDA SILVA CE, MENDONÇA R, SOARES VB, PERON C -Aborgagem transbasal para o manejo de afecções da base do crânio e craniofaciais J Bras Neurocirurg 18 (3): 50-55, 2007 Relatos DA SILVA CE, MENDONÇA R, SOARES VB, PERON C -Aborgagem transbasal para o manejo de afecções da base do crânio e craniofaciais J Bras Neurocirurg 18 (3): 50-55, 2007
Background: Chondromyxoid fibroma (CMF) is a rare, benign primary bone tumor. The cervical spine is an uncommon site for this tumor, with only 10 reported cases to date and none involving the first cervical vertebra (C1). Case Report: Female patient, 25-year-old monozygotic female twin, presented with cervical pain. Radiographic imaging demonstrated a contrast-enhanced, right-sided lytic lesion of the insufflated type in C1, with a punched-out appearance and extending to the anterior arch. A postero-lateral and a posterior approach were performed in two steps to resect the tumor followed by occipitocervical fixation. Pathology confirmed the diagnosis of CMF. At one year, the patient remains disease free with excellent spinal stability. Conclusion: Spinal surgeons may need to treat rare spinal tumors. Despite the proximity to neural and vascular structures, the goal of surgery is always a radical resection due to high recurrence rates.
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