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[Subcranial approach. Technical aspects and application in craneofacial traumatic pathology]
I Zubillaga-Rodríguez1, M I Falguera-Uceda, G Sánchez-Aniceto
1Servicios de Cirugía Oral y Maxilofacial y de Neurocirugía Hospital Universitario 12 de Octubre. Madrid, Spain. ignaciozubillaga@yahoo.es
Neurocirugia (Asturias, Spain)
|December 18, 2010
Summary
The subcranial approach provides safe and effective surgical access to the anterior cranial base, particularly for traumatic injuries. This method ensures adequate management of the frontal sinus and offers excellent visualization without retracting brain tissue.
Area of Science:
- Neurosurgery
- Maxillofacial Surgery
- Trauma Surgery
Context:
- The anterior cranial base presents complex anatomical challenges for surgical access.
- Traumatic injuries and tumors necessitate specialized surgical techniques for optimal outcomes.
- The subcranial approach has emerged as a viable option for addressing anterior cranial base pathologies.
Purpose:
- To evaluate the efficacy and safety of the subcranial approach for anterior cranial base trauma.
- To analyze surgical techniques, complications, and outcomes associated with this approach.
- To present a review of the subcranial approach in managing frontal sinus and anterior cranial base pathologies.
Summary:
- A retrospective analysis of 50 patients (34 trauma, 16 tumors) treated with the subcranial approach was conducted.
- The study details surgical techniques, including frontal sinus obliteration with bone dust.
- Outcomes included no perioperative mortality and a 29% morbidity rate in post-traumatic cases, with a mean hospital stay of 13 days.
Impact:
- The subcranial approach offers a safe and reliable method for treating anterior cranial base pathologies.
- It provides excellent surgical exposure of the nasal cavity, orbits, and ethmoidal-sphenoid sinuses.
- This technique allows access to the anterior fossa without the need for frontal lobe retraction, minimizing neurological risk.
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