Surgical approach to the posterior fossa in children, including anesthetic considerations and complications: The prone and the sitting position. Technical note - 17/02/21
Abord chirurgical de la fosse cérébrale postérieure chez l’enfant, avec considérations anesthésiques et complications: position en décubitus ventral et position assise. Note technique
, N. Boussard b, R. Guerbouz a, M. Helleringer a, A. Joud a, S. Puget cBienvenue sur EM-consulte, la référence des professionnels de santé.
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| pages | 6 |
| Iconographies | 4 |
| Vidéos | 0 |
| Autres | 0 |
Abstract |
Introduction |
Medulloblastoma (MB) in children is, in most cases, a midline lesion located in the posterior fossa, with a high tendency to invade the fourth ventricle (and sometimes its floor).
Methods |
In this technical note, we present both the sitting and the prone position for children with medulloblastoma. These positions will be described together by deliberately deciding not to oppose one against the other. The park bench position, seldom used in pediatric neurosurgery is not described here. The latter procedure can be useful, however, for MB located more laterally or within the cerebellopontine angle.
Results |
The aim of this technical note is to provide the reader with a step by step procedure (from installation to closure), at least from the author's point of view. A special focus regarding anesthetic considerations is also provided. This anesthesia requires perfect coordination and communication between both the anesthetic and surgical teams. Complications of posterior fossa surgery are mentioned as well. Some of the advantages and disadvantages of each positions are mentioned.
Conclusion |
Only careful installation, respect of certain surgical principles (careful attention of the vermis and dentate nuclei for example), knowledge of anatomy, closure and perioperative monitoring, screening and immediate correction of potentially devastating complications will enable surgeons to obtain the best results from their surgery.
Le texte complet de cet article est disponible en PDF.Keywords : Posterior cerebral fossa, Medulloblastoma, Pediatric neurosurgery, Fourth ventricle, Telovelar approach, Prone position, Sitting position, Complications
Plan
Vol 67 - N° 1
P. 46-51 - février 2021 Retour au numéro
Article précédent
- Signaling pathway deregulation and molecular alterations across pediatric medulloblastomas
- B. Lhermitte, A.F. Blandin, A. Coca, E. Guerin, A. Durand, N. Entz-Werlé
- Surgical management of posterior fossa medulloblastoma in children: The Lyon experience
- B. Grassiot, P.A. Beuriat, F. Di Rocco, P. Leblond, C. Faure-Conter, A. Szathmari, C. Mottolese
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