The clinical application of the telovelar approach in tumor resection of the fourth ventricle

Abstract

Objective To investigate the safety of telovelar approach for removing the fourth ventricle tumors. Methods The clinical data of 30 patients with fourth ventricle tumors was analyzed from July, 2012 to July, 2017 in our hospital. All patients were treated through telovelar approach. Results 25 cases had total tumor resection and 5 cases had subtotal resection. 24 cases recovered well after operation [Glasgow treatment outcome classification (GOS): 5 points]. 4 cases suffered from facial numbness and deviated mouth (GOS: 4 points), limb hemiparesis occurred in one case (GOS: 3 points). One patient died from pulmonary infection (GOS: 1 points). None of the survived patients underwent reticence, and the follow-up duration was 2 to 40 months. No obvious tumor recurrence occurred. Pathology results confirmed: 12 cases of ependymoma, 5 cases of astrocytoma, 2 cases of arachnoid cyst, 2 cases of medulloblastoma, 2 cases of choroid plexus papilloma, 2 cases of metastatic carcinoma, 2 cases of central neurocytoma, 2 cases of hemangioblastoma and 1 case of cavernous hemangioma. Conclusion Resection of the fourth ventricle tumors is very difficult. The tumors can fully be exposed through telovelar approach which avoiding the incision of the vermis and reducing the complications. Key words: Telovelar approach; Fourth ventricle tumors; Total tumor resection; Safety