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目的探讨微创手术在切除第四脑室内病变中的优点和应用要点。方法采用枕骨骨瓣成形、小脑延髓裂入路显微手术切除第四脑室内病变28例,并进行术后治疗及随访。结果病变全切23例,近全切除3例。所有患者未出现瘫痪、后组颅神经损伤、脑脊液漏及小脑性缄默征等与手术入路有关的并发症,无病例死亡。结论经小脑延髓裂入路微创手术能安全有效地切除第四脑室内肿瘤。
Objective To explore the advantages and applications of minimally invasive surgery in resection of fourth ventricle lesions. Methods Twenty-eight cases of fourth ventricle lesions were resected using occipital bone flap and cerebellar medullary approach. Postoperative treatment and follow-up were performed. Results The lesions were totally cut in 23 cases and nearly completely removed in 3 cases. All patients had no complications associated with surgical approaches such as fistula, posterior cranial nerve injury, cerebrospinal fluid leakage, and cerebellar hernia indications. No patient died. Conclusion The minimally invasive transcerebral medullar canal approach can safely and effectively remove the fourth intraventricular tumor.