经小脑延髓裂入路切除第Ⅳ脑室肿瘤

Resection of neoplasm in fourth ventricle through cerebello-medullary fissure oppoach

目的探讨经小脑延髓裂入路切除第四脑室内肿瘤的微创技巧和手术优点。方法对20例第Ⅳ脑室内肿瘤均采取枕下正中开颅,经扁桃体下小脑延髓裂入路,显微镜下切除第Ⅳ脑室内肿瘤。结果病变全切除14例,次全切除6例,无手术死亡。结论采用小脑延髓裂入路切除第Ⅳ脑室内肿瘤,可避免切开小脑蚓部,清楚地显示病变,最大限度的保护脑组织,确保手术更加安全,减少了手术并发症。

[Objective] To explore the advantage of eerebello-medullary to reseet the neoplasm in the fourth ventrele region and to discuss the mierosurgieal skills. [Methods] The eraniotomy was through the postenior fossa, and the tonsils of cerebellum was reached by oppenning the tonsillovermian fissure and then moved upward so as to expose the operation field. Neoplasm in the fourth ventricle was reseeted. [Results] Among the 20 cases total resection was in 14 and subtotal resection was in 6. [Conclusion] The eerebello-medullary fissure opproaeh can provide a panoramic view between the two laterl recesses. During operation, the inferior vemis could not be incised. The nervous tissue could be protected and such a oroeedure is much safer.