The Infradentate Approach using a Minimally Invasive Port Technique

Abstract

Introduction: Management of fourth ventricular tumors can be challenging due to the risk of cerebellar mutism in the post-operative period. The incidence of this complication is particularly common in the pediatric population after surgical treatment of medulloblastoma; however, this syndrome is not unique to this population. Many authors believe that splitting of the vermis places patients at risk for this type of mutism, which is characterized by a delayed onset with limited duration and possible persistent dysarthria. To avoid this morbidity from posterior fossa surgery, the authors describe their use of a minimally invasive port technique to access the fourth ventricle without transgressing the vermis or the deep cerebellar nuclei.