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Supracerebellar Infratentorial Paramedian Approach in Helsinki Neurosurgery: Cornerstones of a Safe and Effective Route to the Pineal Region.
- Source :
-
World neurosurgery [World Neurosurg] 2017 Sep; Vol. 105, pp. 534-542. Date of Electronic Publication: 2017 Jun 09. - Publication Year :
- 2017
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Abstract
- Objective: The supracerebellar infratentorial (SCIT) paramedian approach in sitting position represents one of the most used surgical routes for dealing with pineal region lesions. The purpose of this study is to determine the cornerstones to perform this approach in a simple, safe, and effective way, so that it could be easily reproduced in other neurosurgical centers, particularly in those with modest resources.<br />Methods: We reviewed and analyzed the surgical videos of 24 pineal region lesions that were operated on through an SCIT approach between June 2012 and October 2015. The SCIT approach may be divided into 3 main steps: 1) skin-muscle incision; 2) craniotomy; and 3) dura opening and access to the pineal region.<br />Results: Complete lesion removal was accomplished in 23 cases, and subtotal removal was accomplished in 1 case. The pineal region was effectively and safely reached through the SCIT approach in the sitting position with a mean time of 14 minutes, using a basic set of microsurgical instruments. Cornerstones and potential delaying events were carefully recorded for each of the 3 main steps of the approach. Moreover, we present in a short video a step-by-step guide to perform the SCIT approach in a fast and safe way.<br />Conclusions: A correct application of microsurgical principles may allow to safely and rapidly perform the SCIT approach, therefore offering an effective and relatively atraumatic route for dealing with pineal region lesions.<br /> (Copyright © 2017 Elsevier Inc. All rights reserved.)
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Cerebellum diagnostic imaging
Child
Child, Preschool
Female
Humans
Infratentorial Neoplasms diagnostic imaging
Male
Middle Aged
Patient Positioning methods
Pineal Gland diagnostic imaging
Pinealoma diagnostic imaging
Retrospective Studies
Treatment Outcome
Young Adult
Cerebellum surgery
Infratentorial Neoplasms surgery
Microsurgery methods
Neurosurgical Procedures methods
Pineal Gland surgery
Pinealoma surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1878-8769
- Volume :
- 105
- Database :
- MEDLINE
- Journal :
- World neurosurgery
- Publication Type :
- Academic Journal
- Accession number :
- 28602925
- Full Text :
- https://doi.org/10.1016/j.wneu.2017.06.007