Journal of Korean Neurosurgical Society

  • 제48권2호
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  • Pages.139-144
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  • 2010
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  • 2005-3711(pISSN)
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  • 1598-7876(eISSN)
대한신경외과학회 (The Korean Neurosurgical Society)
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Tailored Surgical Approaches for Benign Craniovertebral Junction Tumors

  • Jung, Seung-Hoon (Department of Neurosurgery, Chonnam National University Hwasun Hospital & Medical School) ;
  • Jung, Shin (Department of Neurosurgery, Chonnam National University Hwasun Hospital & Medical School) ;
  • Moon, Kyung-Sub (Department of Neurosurgery, Chonnam National University Hwasun Hospital & Medical School) ;
  • Park, Hyun-Woong (Department of Neurosurgery, Chonnam National University Hwasun Hospital & Medical School) ;
  • Kang, Sam-Suk (Department of Neurosurgery, Chonnam National University Hwasun Hospital & Medical School)
  • 투고 : 2010.04.14
  • 심사 : 2010.08.03
  • 발행 : 2010.08.28
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초록

Objective : We report our surgical experience in the treatment of 16 consecutive patients with benign craniovertebral junction (CVJ) tumor, observed from 2003 to 2008 at our department. Methods : We had treated 6 foramen magnum meningiomas, 6 cervicomedullary hemangioblastomas, 1 accessory nerve schwannoma, 1 hypoglossal nerve schwannoma, 1 C2 root schwannoma, and 1 cavernous hemangioma. Clinical results were evaluated by Karnofsky Performance Scale (KPS) and all patients underwent preoperative neuroradiological evaluation with computed tomography (CT) and magnetic resonance image (MRI). Angiography was performed in 15 patients and preoperative embolization was done in 2 patients. Results : Five far-lateral, 1 supracondylar and 10 midline suboccipital approaches were performed. Gross total removal was achieved in 15 cases (94%) and subtotal removal in 1 patient (6%). None of the patients required occipitocervical fusion. Radiological follow-up showed no recurrence in cases totally removed. Postoperative decrease of KPS scores was recorded in only 1 patient. The treatment of cervicomedullary solid hemangioblastoma presented particular issues : by preoperative embolization, we removed tumor totally without an excessive bleeding or brainstem injury. In one of foramen magnum meningioma, we carried out subtotal removal due to hard tumor consistency and encasement of neurovascular structures. Conclusion : The choice of surgical approaches and the extent of bone resection should be defined according to the location and size of individual tumors. Moreover, we emphasize that preoperative neuroradiological evaluations on presumptive tumor type could be helpful to the surgeon in tailoring the technique and providing the required exposure for different lesions, without unnecessary surgical steps.

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참고문헌

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피인용 문헌

  1. Preoperative liquid embolization of cerebeller hemangioblastomas using N-butyl cyanoacrylate vol.54, pp.9, 2010, https://doi.org/10.1007/s00234-011-0985-5
  2. Foramen magnum meningiomas: surgical results and risks predicting poor outcomes based on a modified classification vol.126, pp.3, 2010, https://doi.org/10.3171/2016.2.jns152873
  3. Foramen magnum meningiomas: surgical results and risks predicting poor outcomes based on a modified classification vol.126, pp.3, 2010, https://doi.org/10.3171/2016.2.jns152873