经小脑延髓裂入路手术治疗第四脑室肿瘤

Management of neoplasms in the fourth ventricle by cerebellomedullary approach

目的探讨微创手术在切除第四脑室内病变中的优点和应用要点。方法采用枕骨骨瓣成形、小脑延髓裂入路显微手术切除第四脑室内病变28例,并进行术后治疗及随访。结果病变全切23例,近全切除3例,因肿瘤与脑干粘连紧密大部分切除2例。所有患者未出现瘫痪、后组颅神经损伤、脑脊液漏及小脑性缄默征等与手术入路有关的并发症,无死亡病例。结论经小脑延髓裂入路微创手术能安全有效地切除第四脑室内肿瘤。

Objective To study the advantage and major features of minimally invasive management of neoplasms in the fourth ventricle. Methods Twenty- eight cases of the fourth ventricle neoplasms underwent craniotomy through the cerebellomedullary fissure approach. Postoperative treatment and follow - up information were studied. Results Of the 28 studied cases, total resection was achieved in 23, and subtotal resection in 3. No approach - related complications such as cerebellar mutism, injury of posterior cranial nerves and hemiplegia occured. Conclusion The minimally invasire management of neoplasms of the fourth ventricle by cerebellomedullary fissure approach is safe and effective.