小脑延髓裂入路切除儿童第四脑室肿瘤临床观察

The clinical observation of cerebellmedullary fissure approach to resect the fourth ventricle tumor in children

目的观察经小脑延髓裂入路(TCMCF)手术切除儿童第四脑室肿瘤的临床疗效。方法对20例第四脑室肿瘤患儿采用枕下正中切口、小脑延髓裂入路在手术显微镜下切除第四脑室肿瘤。结果本组手术全切除17例,次全切除3例。术后患者头晕、头痛症状得以缓解;共济失调8例患者中,术后改善5例;17例术前有脑积水的患者,术后脑室不同程度缩小。结论 TCMCF切除儿童第四脑室肿瘤无需切开小脑蚓部,可避免损伤正常小脑组织,暴露范围广,能显著提高手术疗效。

Objective To evaluate the clinical effect of eerebellomedullary fissure approach to resect the fourth ventricle tumor in children. Methods 20 cases child of the fourth ventricle tumor had been operated on through the posterior fossa craniotomy and cerebell medullary fissure approach. Results Total turmor resection was achieved in 17 cases patients and subtotal in 3 cases patients. Postoperative dlzziness,headache symptoms eased;8 cases patients with ataxia,5 cases patients im- proved after surgery ; 17 cases patients with hydrocephalus before surgery, varying degrees of narrowing after ventricle. Conclusion Cerebellmedullary fissure approach needn＇t dissect vermis,which can avoid damage normal cerebellum and provid a larger area of exposure, elevate curative effection.