Arnold-Chiari Malformation

Maxwell, Megan

doi:10.1007/978-3-319-59680-8_13

Cited by 1 publication

(1 citation statement)

References 21 publications

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“…are many problems which occur caused by tonsillar herniation, either due to CSF flow abnormality, brainstem, or cerebellar compression. These symptoms also ranging from mild to severe problem of the patients [7], [8], [9]. Symptoms of the patient are fluctuate that follow the dynamic intracranial pressure and may be induced by Valsalva [2].…”

Section: Symptoms Improvementmentioning

confidence: 99%

Comparison between Dura-Splitting Technique with Duraplasty in Symptomatic Patients with Chiari Malformation Type I: A Systematic Review and Meta-analysis

Mahadewa

Awyono

Maliawan

et al. 2022

Open Access Maced J Med Sci

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BACKGROUND: There are many surgical procedures for CIM patients, posterior fossa decompression with fibrous band excision, with additional duraplasty, or syringosubdural shunt for syringomyelia related CIM. Prospective studies have been carried out but yet no conclusion, on which one is the best option. The objective of this study was to assess qualitatively the outcome of posterior fossa decompression with dura-splitting (PFDDS) technique compared to posterior fossa decompression with duraplasty (PFDDP) for treating CIM patients. AIM: This study aimed to give us a preference while conducting surgery in a patient with Chiari malformation type I (CIM) between posterior fossa decompression with incision of the fibrous band of the dura (dura-splitting/DS) technique and duraplasty (DP) technique. METHODS: The analysis conducted using PRISMA flowchart with PICO framework (Patient: Chiari malformation type I patient over preschool age; Intervention: Dura-splitting; Comparison: Duraplasty; and Outcome: Complication rate, length of stay, reoperation rate, syrinx reduction, symptomatic improvement, and operation time) and already registered for meta-analysis study with database searching from PubMed, the Cochrane Library, and Google Scholar that following inclusion criteria: (1) Original study; (2) study that compares DS and DP in CM- I; and (3) patient age over preschool age. RESULTS: A review of five included studies involving 458 patients met the inclusion criteria, in which 319 patients treated with DS surgery and 139 for DP surgery for this study. Significantly DS technique correlated lower rate of complication (RR = 0.20; p < 0.0001), shorter length of stay (MD = −3.53; p = 0.0002), and shorter operation time (MD = −58.59; p = 0.0004). No significant differences in reoperation rate (RR = 1.90; p = 0.22), symptom improvement (RR = 1.12; p = 0.44), and syrinx reduction (RR = 1.11; p = 0.56) were noted. CONCLUSIONS: Posterior fossa decompression using the DS technique is associated with a lower rate of complication, shorter length of stay, and shorter operation time. However, no significant differences were found in the reoperation rate, symptom improvement, and syringomyelia reduction between these two techniques.

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Section: Symptoms Improvementmentioning

confidence: 99%