Reyes-Soto Gervith, Corona De la Torre Alfonso, Honda Partida Kaori Guadalupe, Nurmukhametov Renat, Encarnacion Ramirez Manuel De Jesus, Montemurro Nicola
Department of Head and Neck, Unidad de Neurociencias, Instituto Nacional de Cancerología, Mexico City 14080, Mexico.
Neurological Surgery, Peoples Friendship University of Russia, 103274 Moscow, Russia.
Brain Sci. 2024 Mar 5;14(3):254. doi: 10.3390/brainsci14030254.
Craniocervical tumors lead to cervical pain, instability, and neurological symptoms, reducing the quality of life. Effective surgical intervention at the craniocervical junction (CCJ) is critical and complex, involving comprehensive approaches and advanced reconstructive techniques. This study, conducted at Mexico City's National Institute of Cancerology, focused on three surgical cases that occurred in 2023 involving tumors at the CCJ: two chordomas and one prostate adenocarcinoma. We utilized a specialized technique: clivus-cervical stabilization reinforced with a polymethylmethacrylate (PMMA)-filled cervical mesh. Postoperatively, patients showed marked neurological recovery and reduced cervical pain, with enhanced Karnofsky and Eastern Cooperative Oncology Group (ECOG) scores indicating improved life quality. The surgical technique provided excellent exposure and effective tumor resection, utilizing PMMA-filled cervical mesh for stability. Tumoral lesions at the CCJ causing instability can be surgically treated through a transoral approach. This type of approach should be performed with precise indications to avoid complications associated with the procedure.
颅颈肿瘤会导致颈部疼痛、不稳定和神经症状，降低生活质量。颅颈交界区（CCJ）的有效手术干预至关重要且复杂，需要综合方法和先进的重建技术。这项在墨西哥城国家癌症研究所进行的研究聚焦于2023年发生的三例涉及CCJ肿瘤的手术病例：两例脊索瘤和一例前列腺腺癌。我们采用了一种特殊技术：用填充聚甲基丙烯酸甲酯（PMMA）的颈椎网加强斜坡-颈椎稳定。术后，患者神经功能明显恢复，颈部疼痛减轻，卡诺夫斯基和东部肿瘤协作组（ECOG）评分提高，表明生活质量改善。该手术技术提供了良好的暴露并实现了有效的肿瘤切除，利用填充PMMA的颈椎网实现稳定。CCJ处导致不稳定的肿瘤性病变可通过经口入路进行手术治疗。这种入路应在有精确指征的情况下进行，以避免与该手术相关的并发症。
