The microscopic surgical treatment for tumor of posterior cranial fossa in children

Chen, Duo; Wei, Xiao‐Hong; Yin, Qiang; Guan, Junhong; Pan, Wei; Wang, Chenglin; Liu, Yunhui

doi:10.1007/s11805-009-0095-x

Cited by 3 publications

(2 citation statements)

References 9 publications

(11 reference statements)

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“…This feature was also observed in the present cases. Early manifestations of nervous system injuries are usually ignored, as noted in the current study, which is why tumors are generally large at diagnosis (35). In the present study, increased intracranial pressure and obstructive hydrocephalus were the most common early symptoms of ependymomas of the fourth ventricle.…”

Section: Discussionsupporting

confidence: 50%

“…Ependymoma is one of the most common tumors of the fourth ventricle, particularly in pediatric patients (1,2,9). Due to its deep location and close association with the surrounding brain stem, important peripheral nerves and blood vessels, the radical surgical removal of ependymomas of the fourth ventricle is considerably risky (9,14,19,30,34,35). Since pediatric patients are constantly growing and developing, their clinical manifestations lack specificity and accuracy in description (35).…”

Section: Discussionmentioning

confidence: 99%

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Microsurgical management of pediatric ependymomas of the fourth ventricle via the trans-cerebellomedullary fissure approach: A review of 26 cases

Qiu

Wang

et al. 2016

Oncology Letters

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Abstract. In the present study, the microsurgical management of 26 ependymomas of the fourth ventricle in children via the trans-cerebellomedullary fissure (CMF) approach was reviewed and evaluated. Clinical data were obtained from 26 ependymomas of the fourth ventricle treated with microsurgery using the trans-CMF approach from March 2006 to September 2010 at the Department of Neurosurgery of The First Affiliated Hospital of China Medical University (Shenyang, China). These data were collected and analyzed. Suboccipital median posterior fossa craniotomy and trans-CMF approach were performed in all cases for the microsurgical removal of the tumors. An additional incision was performed in the inferior medullary velum of 5 patients, in order to obtain adequate exposure of the tumors. As a result, all tumors were well exposed during surgery. Gross total resection (GTR) was achieved in 22 cases, near total resection (NTR) in 3 cases and subtotal resection (STR) in 1 case. All excised tumors were pathologically confirmed. No mortality occurred intraoperatively, and no patient presented with mutism or any other surgery-related complications. One patient suffered from postoperative hydrocephalus and received ventriculoperitoneal shunting, which relieved the symptoms. Over the 3.0-7.5-year follow-up period (mean, 4.8 years), tumor relapse occurred in 1 case with GTR, 2 cases with NTR and 1 case with STR. In total, 3 patients succumbed to tumor relapse and 4 were lost to follow-up. According to the literature and the clinical experience of the present authors, the trans-CMF approach provides safe and sufficient access to the fourth ventricle without the requirement of an incision in the inferior vermis. This approach prevents damage to the normal cerebellum and improves the surgical outcome. Tumor removal, restoration of cerebrospinal fluid circulation and preservation of brainstem function are factors that should be taken into consideration during surgery. For patients with residual tumors, adjuvant radiotherapy and/or chemotherapy may be beneficial.

show abstract

Section: Discussionsupporting

confidence: 50%

Section: Discussionmentioning

confidence: 99%

Microsurgical management of pediatric ependymomas of the fourth ventricle via the trans-cerebellomedullary fissure approach: A review of 26 cases

Qiu

Wang

et al. 2016

Oncology Letters

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The benefits of navigated intraoperative ultrasonography during resection of fourth ventricular tumors in children

El-Beltagy

Atteya

2013

Childs Nerv Syst

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Integration of navigated intraoperative ultrasonography in surgery of pediatric fourth ventricular tumors is a useful technology. It safely monitors maximum stepwise tumor excision. It is associated with less operative morbidity without significantly added operative time. It is a real-time, cost-effective, easily applicable, and easily interpretable tool that could substitute the use of intraoperative MRI especially in pediatric neurosurgery.

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Microsurgical Management of Fourth Ventricle Astrocytoma via Median Suboccipital Keyhole Approach: Review of 12 Cases

Lan

2019

World Neurosurgery

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The microscopic surgical treatment for tumor of posterior cranial fossa in children

Cited by 3 publications

References 9 publications

Microsurgical management of pediatric ependymomas of the fourth ventricle via the trans-cerebellomedullary fissure approach: A review of 26 cases

Microsurgical management of pediatric ependymomas of the fourth ventricle via the trans-cerebellomedullary fissure approach: A review of 26 cases

The benefits of navigated intraoperative ultrasonography during resection of fourth ventricular tumors in children

Microsurgical Management of Fourth Ventricle Astrocytoma via Median Suboccipital Keyhole Approach: Review of 12 Cases

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