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《Chinese Journal of Neuromedicine》 2007-11
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Resection of neoplasms involving the fourth ventricle of children via the cerebellomedullary fissure approach

YANG Hong WANG Jian LIANG Jian-min FANG Ze-lu.Department of Neurosurgery,the Second Affiliated Hospital of Guangzhou Medical College,Guangzhou 510260,China  
Objective To investigate the clinical effects and surgical techniques of the transcerebellomedullary fissure approach to resect the fourth ventricle neoplasms in children.Methods All the 32 cases with the fourth ventricle neoplasms underwent resection via the suboceipital median approach or cerebeliomedullary fissure approach,or posterior fossa cranioplasty;some eases also had their cerebellar vermis incised.Results Among the 32 cases,total resection was achieved in 25,and subtotal resection in 7.No died case was found.Symptoms of ataxia and vision decrease in these children were alleviated after the operation.One case developed facial nerve injury and 2 cases developed incomplete mutism after the operation,but all recovered 3 weeks later.Conclusion The transcerebellomedullary fissure approach can provide a panoramic view between the two lateral recesses and from the obex to the aqueduct without incision of cerebellar inferior vermis or injury to cerebellar tissues.The posterior inferior cerebellar artery(PICA)and its branches should be protected during resection.If necessary,neoplasms can be excised through splitting the cerebellar vermis according to the pathological characteristics of neoplasms.
【Fund】: 广东省科技计划项目(2004B33801015)
【CateGory Index】: R739.41
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