Abordaje subcranealdiscusión y revisión histórica de la técnica quirúrgica

Abstract

Introduction. Skull base surgery ¡s now a reality that has become Consolidated over the last decades. The dizzyingly rapid technological advances that have taken place have served as a motor for the development of surgical techniques to approach this anatomic región. The foundation for the definitive push forward of this technique was multidisciplinar/ teamwork. Material and methods. The subcranial approach is described as an alternative to traditional approaches to the skull base. The history of different key steps in the subcranial approach is described and discussed. Discussion. The selection of the most suitable approach to the skull base in each case is essential for obtaining satisfactory surgical results overall. Initially, the selection of an approach depends on the exact anatomic location of the lesión in the skull base, its three-dimensional extensión, as well as the nature of the lesión. The subcranial approach is an important step in the development of surgical techniques for the skull base. Conclusions. The anterior subcranial approach provides ampie and óptima! exposure of a/1 the planes of the anterior cranial fossa, from the anterior ethmoidal roof to the clivus-sphenoid píate, including the orbital roofs. This objective is achieved without having to retract the frontal labes, thus avoiding the associated morbidity and mortality that this maneuver entails. The anterior subcranial approach makes precise earlier management of oncologic pathology with ¡ntradural and extradural involvement possible, as well as the treatment of fractures produced by high-energy impact with involvement of the anterior cranial fossa.