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Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition) ›› 2021, Vol. 11 ›› Issue (01): 41-47. doi: 10.3877/cma.j.issn.2095-123X.2021.01.011

Special Issue:

• Clinical Researches • Previous Articles     Next Articles

Clinical features and surgical approaches of medulloblastoma

Lihua Chen1, Kai Sun1, Wenjin Chen1, Yong Xia1, Hongtian Zhang1, Ruxiang Xu1,()   

  1. 1. Department of Neurosurgery, Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital, Chengdu 610072, China
  • Received:2020-10-17 Online:2021-02-15 Published:2021-06-24
  • Contact: Ruxiang Xu

Abstract:

Objective

To investigate the clinical characteristics and the selection of surgical approach for medulloblastoma (MDB) in children.

Methods

Retrospective analysis of clinical data of 32 children with MDB who were treated by cerebellar medullar fissure (CMF) approach (including 28 cases of unilateral cerebellar medullar fissure approach and 4 cases of bilateral CMF approach) from January 2011 to December 2019 in Neurosurgery Department of Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital. The clinical features and prognosis of the patients were analyzed.

Results

Among 32 cases, 28 patients (87.5%) were <10 years old, 21.9% were <3 years old and 65.6% were male. The longest duration of the disease in all patients was 6 months, and 71.9% cases were within 3 months, the main symptoms were intracranial hypertension and ataxia. Most of the MDBs were located in vermis or midline (90.6%), only 9.4% in cerebellum hemisphere, and 9.4% of MDB oppressed brain stem. The total resection rate was 90.6% in 29 patients, 3 patients were subtotal resection, 1 patient was complicated with cerebellar mutism, full recovery was achieved after 1 month. There were no surgical related deaths and no permanent cerebrospinal fluid leakage.

Conclusion

CMF approach is the optimal surgical approach for MDB, which is in line with minimally invasive surgery principles. Mastering the clinical features of MDB and the principles and skills of CMF approach, combined with the exquisite minimally invasive neurosurgery techniques, contributes to improving the curative effect of MDB.

Key words: Medulloblastoma, Cerebellar medullar fissure approach, Children

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