Abstract:

The brain stem and cerebellum are the main surgical barriers to the fourth ventricle. Cerebellar medullar fissure (CMF) is the natural anatomic fissure among amygdala, cerebellum vermis and medulla oblongata. The CMF operative approach vianatural avascular flat anatomy, thus by excision, incision under the choroid and pith sail, to maximize exposure and scope of work at the same time avoid the cerebellar vermis incision, joint C1 arch after resection, could improved the upper part of the fourth ventricle and direction of exposure, and provide additional surgery path. When medulloblastoma had established a surgical path through the tumor corridor through the median foramen of the fourth ventricle, the exposure of the surgical field was significantly expanded and the traction of the cerebellar tonsils was reduced. In this paper, the design concept, open type, exposure range and advantages and disadvantages of CMF approach are summarized as follows.

Key words: Medulloblastoma, Cerebellar medulla fissure approach, The fourth ventricle