caa a22 4500 463180755 CHVBK 20180406164838.0 cr unu---uuuuu 170326e20070501xx s 000 0 eng 10.1007/s00381-006-0295-0 doi (NATIONALLICENCE)springer-10.1007/s00381-006-0295-0 Telovelar approach: technical issues for large fourth ventricle tumors [Elektronische Daten] [B. Rajesh, B. Rao, G. Menon, M. Abraham, H. Easwer, S. Nair] Objects: Fourth ventricle is conventionally accessed via resection of the part of the vermis for total excision of the tumors at the expense of significant morbidity. Numerous avenues have been identified to minimize the morbidity; some of which include transforaminal, subtonsillar, telovelar approaches, etc. These approaches are devised on the basis that accurate dissection along the natural avascular planes will avoid injury to the important structures in this area minimizing morbidity. We attempt to emphasize the technique of telovelar approach and the problems encountered while employing this technique for excision of large fourth ventricle tumors. Materials and methods: Fifteen patients with fourth ventricle tumors were operated during January to September 2005 at Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India. Fourteen of these cases were medulloblastomas, and one was ependymoma. All the patients were operated in prone oblique position via telovelar approach. Conclusion: Clear understanding of the normal anatomy will help in meticulous dissection and will result in reduced morbidity. Significant incidence of postoperative ataxia and mutism is seen with this approach in large tumors, and this can be avoided by staged dissection of the uvulotonsillar cleft. Springer-Verlag, 2007 Midline posterior fossa tumors nationallicence Telovelar approach nationallicence Surgical implications nationallicence Large tumors nationallicence Rajesh B. Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India aut Rao B. Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India aut Menon G. Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India aut Abraham M. Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India aut Easwer H. Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India aut Nair S. Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India aut Child's Nervous System Springer-Verlag 23/5(2007-05-01), 555-558 0256-7040 23:5<555 2007 23 381 https://doi.org/10.1007/s00381-006-0295-0 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00381-006-0295-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Rajesh B. Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India aut NATIONALLICENCE 700 1- Rao B. Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India aut NATIONALLICENCE 700 1- Menon G. Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India aut NATIONALLICENCE 700 1- Abraham M. Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India aut NATIONALLICENCE 700 1- Easwer H. Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India aut NATIONALLICENCE 700 1- Nair S. Department of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, India aut NATIONALLICENCE 773 0- Child's Nervous System Springer-Verlag 23/5(2007-05-01), 555-558 0256-7040 23:5<555 2007 23 381 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer