A Curative Effect Study And The Prevention Of Postoperative Complications Of The Section Neoplasm In Fourth Ventricle Through Cerebellomedullary Fissure Approach

Objective To explore relative points for attention how to apply transcerebello-medullary fissure approach to separate the fourth ventricle tumors and postoperative complications how to prevent and control.To get more knowledge about the transcer-ebellomedullary fissure approach.Methods We retrospectively analyzed the clinical data of 20 patients with the fourth ventricle tumors between January 2013 and February 2017 in The first affiliated hospital of kunming medical university after microsurgical operation.All patients received suboccipital median posterior fossa craniotomy and transcerebellomedullary fissure approach to resect the tumors micro-surgically.Postoperative observation of patients with tumor resection,subcutaneous effusion after pillow and cerebellar mutism and physical recovery after 6 months.Results Postoperative symptomatic hydrocephalus was found in 5 patients,but it was cured by ventricle abdo-men shunt.Drugs were given to 4 patients with intracranial pneumatocele,4 with intracranial infection,and 2 with upper gastrointestinal hemorrhage.Five patients out of the 16 tracheotomies recovered well by mechanical ventilation.there are no subcutaneous effusion cases and cerebellar mutism after pillow.Headache,dizziness,ataxia symptoms were improved after operation.KPS was used to evaluate the patients situation 6 months after operation;1 case with 100 scores,3 cases with 90 scores,10 cases with 80 scores,5 cases with 70scores,1 cases with 60 scores.A 10-33 month follow-up of 20 cases showed that 20 case were good recovery,3 cases were relapse(1 cases of mortality).Conclusions application of transcerebellomedullary fissure approach to resect the fourth ventricle tumor is safe and effective method?The transcerebellomedullary fissure approach can provide a panoramic view between the two lateral recesses and from obex to aqueduct and decrease the incidence of postoperative cerebellar silent syndrome and other complications with the separation of the choroid and inferior medullary velum?...