The selection of craniotomy type for removal of posterior cranial fossa tumors at children
Abstract
Objective: to clarify the indications for osteoplastic craniotomy (OPC) and decompressive trepanation (DT) at children with tumors of posterior cranial fossa (PCF). Material and methods. We present the analysis of suboccipital craniotomy methods at 53 children at the age from 3 months till 17 years with PCF tumors, operated on in Russian Scientific Research Neurosurgical Institute n.a. A.L. Polenov during period from 2007 till 2009. We conducted the comparative examination of postoperative period features including estimation of biomechanical characteristics of craniospinal system (CSS) in two groups of patients: I group - DT, II group - OPC. Results. The both studied group were comparable according to radicality of tumor removal. Pseudomeningocele were seen at 7 (29,2%) patients and liquorrhea - at 4 (16,6%) patients in I group; there were no such complications at patients in II group. Infectious complications were seen at 3 (12,5%) patients in I group and at 2 (6,8%) patients in II group. The liquorshunt operations for correction of postoperative hydrocephalus were performed at 6 (25%) patients in I group and at 4 (13,8%) patients in II group. The monitoring of liquor pressure as well as measurement of pressure-volume interrelation (PVI CSS) revealed no significant difference between groups (р>0,3) after total resection of tumor. Conclusion. OPC should be the method of choice for surgical treatment of children with PCF tumors. DT of PCF in children is significantly more often accompanied by postoperative complications associated with the presence of trepanation window that is why the usage of DT at such patients requires the presence of additional indications. The algorithm for choice of trepanation method at children with PCF tumors was offered.
About the Authors
A. V. Kim
ФГБУ РНХИ им. проф. А.Л. Поленова
Russian Federation
Russian Federation
K. A. Samochernykh
ФГБУ РНХИ им. проф. А.Л. Поленова
Russian Federation
Russian Federation
O. A. Don
ФГБУ РНХИ им. проф. А.Л. Поленова
Russian Federation
Russian Federation
V. A. Khachatrian
ФГБУ РНХИ им. проф. А.Л. Поленова
Russian Federation
Russian Federation
References
1. Гаспарян С.С. Методы количественной оценки параметров ликвородинамики // Вопросы нейрохирургии - 1985. - № 5. - С. 51-57.
2. Крылов В.В. Лекции по черепно-мозговой травме. Учебное пособие. - М.: Медицина. - 2010. - С. 320.
3. Лебедев В.В., Крылов В.В., Ткачев В.В. Декомпрессивная трепанация черепа // Нейрохирургия. - 1998. - № 2. - С. 38-42.
4. Ромоданов А.П., Зозуля Ю.А., Мосийчук Н.М., Чушкан Г.С. Атлас операций на головном мозге; АМН СССР. - М.: Медицина, 1986. - С. 153-171.
5. Тиглиев Г.С. Олюшин В.Е., Кондратьев А.Н. Внутричерепные менингиомы. - СПб: Изд-во РНХИ им. проф. А. Л. Поленова, 2001. - С. 560.
6. Хачатрян В.А., Берснев В.П., Сафин Ш.М., Орлов Ю.А., Трофимова Т.Н. Гидроцефалия (патогенез, диагностика, хирургическое лечение). - СПб.: Изд-во РНХИ им. проф. А.Л. Поленова, 1998. - С. 234.
7. Хачатрян В.А., Ким А.В., Самочерных К.А. и др. Диагностика осложнений послеоперационного периода хирургического лечения опухолей субтенториальной локализации // Материалы III Российского конгресса «Современные технологии в педиатрии и детской хирургии». Москва. - 2004. - С. 413-414.
8. Хачатрян В.А., Ким А.В., Солтан П.С., Сахно Л.С., Дон О.А. Реконструкция биомеханики краниоспинальной системы при опухолях задней черепной ямки у детей // Материалы научно - практической конференции нейрохирургов Украины «Проблемы реконструктивной и восстановительной нейрохирургии» (АР Крым, г. Партенит, 7-8 октября 2010 г.). Украинский нейрохирургический журнал. - 2010. - № 3. - С. 61.
9. Al-Mefty O. Operative atlas of meningiomas - Philadelphia: Lipincott-Raven, 1998. - Р. 425-429.
10. Catalano P., Jacobowitz O., Post K. Prevention of headache after retrosigmoid removal of acoustic tumors // Am. J. Otol. - 1996. - № 17. - Р. 904-908.
11. Chou Y., Sarkar R., Osuagwu F., Lazareff J. Suboccipital craniotomy in the surgical treatment of Chiari I malformation // Childs Nerv. Syst. - 2009. - № 25. - Р. 1111 -1114.
12. Cushing H. Subtemporal decompressive operation for the intracranial complications associated with bursting fractures of the skull // Ann. Surg. - 1908. - № 47. - Р. 641- 644.
13. Dujovny M., Fernandes P., Alperin N. Post-cranioplasty cerebrospinal fluid hydrodynamic changes: magnetic resonance imaging quantitative analysis // Neurol. Res. - 1997 - № 19. - Р. 311-316.
14. Dujovny M., Aviles A., Agner C. et al. Cranioplasty: cosmetic or therapeutic? // Surg. Neurol. - 1997. - № 47. - Р. 238241.
15. Donald J. Cranial defects and cranioplasty // In Wilkins R.H. and Rengachari S.S. (ed) Neurosurgery - New York: McGraw-Hill, 1985. - P. 1648.
16. Feghali J.G., Elowitz E.H. Split calvarial graft cranioplasty for the prevention of headache after retrosigmoid resection of acoustic neuromas // Laryngoscope. - 1998. - Vol. 108(10) - Р. 1450-1452.
17. Fetterman B, Lanman T., House J. Relief of headeche by cranioplasty after skull base surgery // Skull Base Surg. - 1997. - № 7. - Р. 1-4.
18. Gardiner W.J. Closure of defects of the skull with tantalum // Surg. Gynecol. Obstet. - 1945. - № 80. - Р. 303 -312.
19. Gnanalingham K.K., Lafuente J., Thompson D., Harkness W., Hayward R. Surgical procedures for posterior fossa tumors in children: does craniotomy lead to fewer complications than craniectomy? // J. Neurosurgery - 2002. - № 97. - Р. 821-826.
20. Grant F., Norcross N. Repair of cranial defects by cranioplasty // Ann. Surg. - 1939. - № 110. - Р. 488 - 512.
21. Grover K., Sood S. Midline suboccipital burr hole for posterior fossa craniotomy // Childs Nerv. Syst. - 2010. - № 26. - Р. 953-955.
22. Harner S., Beaty C., Egersold M. Headache after acoustic neuroma excision // Am. J. Otol. - 1993. - № 14. - Р. 552-555.
23. Harner S., Beaty C, Egersold M. Impact of cranioplasty on headeche after acoustic neuroma removal // Neurosurgery. - 1995. - № 36. - Р. 1097-1099.
24. Hayward R. Posterior fossa craniotomy: an alternative to craniectomy // Pediatr. Neurosurg. - 1999. - № 31. - Р. 330.
25. Jannetta P.J., Lovely T.J., Lowry D.W. Functional outcome and the effect of cranioplasty after retromastoid craniectomy for microvascular decompression // Surg. Neurol. - 1999. - Vol. 51(2) - Р. 191-197.
26. Kurpad S.N., Cohen A.R. Posterior fossa craniotomy: an alternative to craniectomy // Pediatr. Neurosurg. - 1999. - № 31. - Р. 54-57.
27. Landeiro J., De Castro I., Flores M., Teixeira Maia J. Posterior fossa craniotomy. Technical report. // Arq. Neuropsiquiatr. - 2000. - Vol. 58(1) - Р. 169-173.
28. Marmarou A., Shulman К., Rosende R. A nonlinear analysis of the cerebrospinal fluid system and intracranial pressure dynamic // J. Neurosurgery - 1978. - Vol. 48. - P. 332-344.
29. Ogilvy C.S., Ojemann R.G. Posterior fossa craniotomy for lesions of the cerebellopontine angle: technical note // J. Neurosurg. - 1993. - № 78. - Р. 508-509.
30. Prell J., Scheller C., Alfieri A., Rampp S., Rachinger J. Midline-craniotomy of the posterior fossa with attached bone flap: experiences in paediatric and adult patients // Acta Neurochir. - 2011. - № 153. - P. 541-545.
31. Raimondi A., Choux M., C. Di Rocco. Posterior fossa tumors // Springer-Verlag, 1993. - Р. 214.
32. Samii M., Matthies C. Management of 1000 Vestibular Schwannomas (Acoustic Neuromas): Surgical Management and Results with an Emphasis on Complications and How to Avoid Them // Neurosurgery. - 1997. - Vol. 40(1) - Р. 11-21.
33. Santarius T., D’Sousa A.R., Zeitoun H.M., Cruickshank G., Morgan D.W. Audit of headache following resection of acoustic neuroma using three different techniques of suboccipital approach // Rev. Laryngol. Otol. Rhinol. (Bord) - 2000. - Vol. 121 (2) - Р. 75-78.
34. Schaller B, Baumann A. Headache after removal of vestibular schwannoma via the retrosigmoid approach: a long-term follow-upstudy // Otolaryngol. Head Neck Surg. - 2003. - Vol. 128(3) - Р. 387-395.
35. Schessel D.A., Nedzelski J.M., Rowed D., Feghali J.G. Pain after surgery for acoustic neuroma // Otolaryngol. Head Neck Surg. - 1992. - Vol. 107(3) - Р. 424-429.
36. Schiffer J., Gur R., Nisin U. Pollak L. Symptomatic patients after craniectomy // Surg. Neurol. - 1997. - № 47. - Р. 231-237.
37. Segal D.H., Oppenheim J.S., Murovic J.A. Neurological recovery after cranioplasty // Neurosurgery. - 1994. - № 34. - Р. 729-731.
38. Silverman D.A., Hughes G.B., Kinney S.E., Lee J.H. Technical modifications of suboccipital craniectomy for prevention of postoperative headache // Skull Base. - 2004. - Vol. 14(2) - Р. 77-84.
39. Soumekh B., Levine S., Haines S., Wulf J. Retrospective study of postcraniotomy headeche in suboccipital approach: Diagnosis and management // Am. J. Otol. - 1996. - № 17. - Р. 617-619.
40. Steinbok P., Cochrane D.D. Posterior fossa craniotomy: an alternative to craniectomy: an alternative to craniectomy // Pediatr. Neurosurg. - 2000. - № 32. - Р. 110.
41. Yasargil M.G., Fox J.L. The microsurgical approach to acoustic neurinomas // Surg. Neurol. - 1974. - № 2. - Р. 393-398.
Review
For citations:
Kim A.V., Samochernykh K.A., Don O.A., Khachatrian V.A. The selection of craniotomy type for removal of posterior cranial fossa tumors at children. Russian journal of neurosurgery. 2013;(3):24-29. (In Russ.)
Views:
1364
Email this article 