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- Title
Comparison of transvermian and telovelar methods in fourth ventricular surgical approaches: a surgical neuroanatomy study.
- Authors
Salman, Necati; Sayın, Bedriye Nur; Yücealp, Mehmet Burak; Kavrazli, Miraç Can; Mamadov, Nuraddin; Ebrahimpourgajouti, Sama; Serin, Kübra; Musayev, Bengisu; Kahioğulları, Gökmen; Cömert, Ayhan
- Abstract
Objective: The traditional approach in fourth ventricular surgery is the transvermian approach, which involves reaching the ventricle with a vertical incision over the vermis of cerebellum. However, encountering mutism-like findings in patients who underwent this method has led to the search for a new surgical method. Among these methods, the telovelar approach uses the method of reaching the fourth ventricle by dissecting the velum medullare inferius structures, which are reached using fissure lines. With the difference in complications, both methods provide the opportunity to reach different parts within the fourth ventricle. Our study aims to reveal the differences in the applications of both methods by making angle and morphometric measurements in cerebellum materials. Methods: In our study, 10 cerebellum materials obtained from heads fixed with formalin were used. Length measurements on the dissected materials were recorded in millimeters (mm) by using a caliper. Angle measurements were recorded in degrees (°). The area reached in the ventricle with both methods was measured and compared with the ImageJ program. Fossa rhomboidea dimensions and area were used as fourth ventricular measurement parameters. In the study method, firstly, transvermian and telovelar standard intervention points were determined. The line on the sulcus medianus was divided into 10 equal points between the obex and aquaductus mesencephali. For each intervention, the points on the sulcus medianus were targeted separately and the angles of intervention were measured. Results: Compared to the transvermian intervention, lower intervention angles were detected in the telovelar intervention trials. Considering the catheter distances applied in the interventions, longer distance and longer fourth ventricular height / catheter distance ratio were determined in transvermian interventions compared to the telovelar interventions. Conclusion: When the telovelar approach is applied with different planes and different application angles, it can reach the points determined at the base of the fourth ventricle. The difference in the transportation distances of the surgical methods supports the view that the telovelar method causes less tissue damage compared to the transvermian approach.
- Subjects
LENGTH measurement; NEUROANATOMY; CEREBELLUM; FORMALDEHYDE
- Publication
Anatomy: International Journal of Experimental & Clinical Anatomy, 2022, Vol 16, pS30
- ISSN
1307-8798
- Publication type
Abstract