neurosurgeryНейрохирургияRussian journal of neurosurgery1683-32952587-7569Издательский дом "МедИНК"10.17650/1683-3295-2018-20-2-8-16neurosurgery-546Research ArticleОРИГИНАЛЬНАЯ РАБОТАORIGINAL REPORTХирургическое лечение объемных образований IV желудочка с использованием теловелярного доступаSurgical treatment of the tumors of the fourth ventricle through telovelar approachhttps://orcid.org/0000-0001-7003-5549КалиновскийА. В.KalinovskiyA. V.

Антон Владимирович Калиновский

 630087 Новосибирск, ул. Немировича-Данченко, 132/1

akalinovsky1980@gmail.comhttps://orcid.org/0000-0002-7039-7010ЧерновС. В.ChernovS. V.

630087 Новосибирск, ул. Немировича-Данченко, 132/1

https://orcid.org/0000-0002-8122-4879ЗотовА. В.ZotovA. V.

630087 Новосибирск, ул. Немировича-Данченко, 132/1

https://orcid.org/0000-0002-0331-625XКасымовА. Р.KasymovA. R.

630087 Новосибирск, ул. Немировича-Данченко, 132/1

https://orcid.org/0000-0002-7996-8449ГормолысоваЕ. В.GormolysovaE. V.

630087 Новосибирск, ул. Немировича-Данченко, 132/1

https://orcid.org/0000-0003-1684-4921УжаковаЕ. К.UzhakovaE. K.

630087 Новосибирск, ул. Немировича-Данченко, 132/1

ФГБУ «Федеральный центр нейрохирургии» Минздрава России (Новосибирск)РоссияFederal Neurosurgical Center (Novosibirsk), Ministry of Health of RussiaRussian Federation201819072018202816Copyright © Калиновский А.В., Чернов С.В., Зотов А.В., Касымов А.Р., Гормолысова Е.В., Ужакова Е.К., 20182018Калиновский А.В., Чернов С.В., Зотов А.В., Касымов А.Р., Гормолысова Е.В., Ужакова Е.К.Kalinovskiy A.V., Chernov S.V., Zotov A.V., Kasymov A.R., Gormolysova E.V., Uzhakova E.K.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.therjn.com/jour/article/view/546

Цель исследования – анализ результатов хирургического лечения взрослых пациентов с объемными образованиями IV желудочка и определение предикторов неудачных исходов.

 Материалы и методы

 Материалы и методы. В Федеральном центре нейрохирургии (Новосибирск) были прооперированы теловелярным доступом 33 взрослых пациента с объемными образованиями IV желудочка. В большинстве случаев до лечения наблюдались гидроцефалия (54,5 %), мозжечковые нарушения (33,3 %), поражение черепных нервов (30,3 %). У 22 пациентов размер опухоли превышал 40 мм (66,7 %). В 21 (63,6 %) случае в опухолевый процесс были вовлечены структуры ствола и дно ромбовидной ямки.

Результаты

Результаты. Тотально были удалены 23 (69,7 %) образования. Окклюзионная гидроцефалия регрессировала у 17 (94,5 %) из 18 пациентов. Ни в одном случае не было признаков повреждения червя мозжечка и появления мозжечкового мутизма.

Заключение

Заключение. Предикторами неудачных исходов могут быть сочетание таких факторов, как инвазия образования в ствол мозга, нерадикальное удаление, наличие предоперационной гидроцефалии. По нашему мнению, у пациентов с образованиями IV желудочка необходимость в предоперационных ликворошунтирующих операциях в большинстве случаев отсутствует.

The study objective is analysis of surgical treatment results of adult patients with tumors of the fourth ventricle and determination of predictors of unsuccessful outcomes.

Materials and methods

Materials and methods. In the present study we review results of treatment of 33 adult patients with tumors of the fourth ventricle, which were operated via telovelar approach in Federal Neurosurgical Center (Novosibirsk). The most common symptoms included hydrocephalus (54.5 %), cerebellar dysfunction (33.3 %), cranial nerve deficits (30.3 %). The tumor size was more than 40 mm in 22 cases (66.7 %). The brain stem invasion was occurred in 21 cases (63.6 %).

Results

Results. 23 tumors were removed totally (69.7 %). Hydrocephalus was regressed in 17 cases (94.5 %). Cerebellar mutism did not occur in any patient.

 Conclusion

 Conclusion. Predictors of poor result may be brain stem invasion, non-radical resection of tumor and preoperative hydrocephalus. We suggest, that the preoperative hydrocephalus should not been operated in the most cases of the fourth ventricular tumors.

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The authors declare that there are no conflicts of interest present.