Tehran University of Medical Sciences

Science Communicator Platform

Stay connected! Follow us on X network (Twitter):
Share By
Surgical Management of the Fourth Ventricular Tumors Using Telovelar Approach and the Role of Neuroendoscopy: Post-Operative Outcome and Long-Term Results in a Series of 52 Cases Publisher Pubmed



Maloumeh EN1 ; Khoshnoud RJ2 ; Ebrahimzadeh K1 ; Tavassol HH1 ; Salari S1 ; Mousavinejad A1 ; Kargari A3 ; Samadian M1 ; Rezaei O1
Authors

Source: Clinical Neurology and Neurosurgery Published:2021


Abstract

Objectives: The telovelar approach is a surgical method performed through natural corridors of the brain to access the fourth ventricle. The aim of this study is to assess the results of this approach as well as the role of neuroendoscopy in surgical management of fourth ventricle tumors. Material and Methods: A retrospective study was designed, and a series of 52 consecutive patients (32 male, 20 female) with fourth ventricle tumor undergoing telovelar approach was undertaken. In 10 patients (19 %) with a tumor invading the rostral fourth ventricle, an adjustable angle endoscope was also used to ensure total resection of the tumor. Results: Complete resection was obtained in majority of patients (94 %). 30 patients (57 %) required insertion of an external ventricular drain which was discontinued in all patients after 72 h. 2 patients (4 %) underwent permanent ventriculoperitoneal shunt. The postoperative complications included meningitis (8 %), transient facial nerve paralysis (8 %), transient sixth cranial nerve paralysis (6 %) and transient unilateral absence of the gag reflex (4 %). No patient experienced mutism and there was a mortality rate of 2 % (1 case) in current study. Conclusion: In our experience, a high rate of total resection of the fourth ventricle tumors could be achieved with the telovelar approach associated with a low risk of surgical morbidity and mortality. Moreover, the use of an adjustable angle endoscope could be useful in patients with a tumor involving the rostral fourth ventricle to ensure total resection of the tumor and also to minimize the extent of telovelar dissection. © 2020 Elsevier B.V.
Other Related Docs