目的:探讨小脑延髓裂入路在切除第四脑室内病变中的应用价值。方法:采用小脑延髓裂入路显微手术切除第四脑室内病变 19例 ,其中 2例第四脑室内长入幕上的巨大肿瘤 ,需结合切开小脑蚓部全切肿瘤。 结果 :病变全切 19例 ,1例病人出现上消化道出血 ,其中切开小脑蚓部的 1例病人出现小脑缄默综合征 ,其余病人未出现与手术入路有关的并发症。结论:小脑延髓裂入路是切除第四脑室内肿瘤的损伤小、安全且暴露清楚的手术入路 Objective: To investigate the application value of medulla oblongata in the removal of the fourth intracranial lesions. Methods: Microsurgery of cerebellar medulla oblongata was used to excise the fourth intracerebral lesions in 19 cases. Two of them formed huge tumors in the fourth ventricle. Results: Twenty-nine cases were completely resected and one case had upper gastrointestinal hemorrhage. One patient with cerebellar vermis was diagnosed with cerebellar mucromyces syndrome and the rest had no complication associated with surgical approach. Conclusions: Cerebellar bulbar approach is a safe and well-exposed surgical approach for resection of the fourth ventricle