Sanford Robert A, Merchant Thomas E, Zwienenberg-Lee Marike, Kun Larry E, Boop Frederick A
Semmes-Murphey Clinic, 6325 Humphreys Boulevard, Memphis, TN 38120, USA.
Childs Nerv Syst. 2009 Oct;25(10):1229-40. doi: 10.1007/s00381-009-0886-7. Epub 2009 May 30.
Childhood cerebellopontine angle (CPA) ependymoma is an uncommon anatomical variant of posterior fossa ependymoma. In infants and young children, the tumor often goes undetected until it causes hydrocephalus. As CPA ependymomas grow, they distort the anatomy and encase cranial nerves and vessels, thereby making resection a formidable surgical challenge.
The purpose of this paper is to describe the surgical technique used to achieve gross total resection (GTR) of CPA ependymomas and demonstrate improved survival in these patients.
Surgical techniques used for GTR in 45 patients with CPA ependymoma treated from 1997 to 2008 are described. Results of those procedures are compared with data from 11 patients who previously underwent surgical resection (1985-1995).
We achieved GTR in 43 (95.6%) patients and near-total resection in two (4.4%); the probability of progression-free survival was 53.8%, and that of overall survival was 64%.
Our novel surgical techniques greatly improve central nervous system function and survival among pediatric patients with CPA ependymoma.
儿童小脑脑桥角（CPA）室管膜瘤是后颅窝室管膜瘤一种罕见的解剖学变异类型。在婴幼儿中，肿瘤常在引起脑积水之前未被发现。随着CPA室管膜瘤的生长，它们会扭曲解剖结构并包裹颅神经和血管，从而使切除成为一项艰巨的手术挑战。
本文旨在描述用于实现CPA室管膜瘤全切除（GTR）的手术技术，并证明这些患者的生存率有所提高。
描述了1997年至2008年期间治疗的45例CPA室管膜瘤患者实现GTR所采用的手术技术。将这些手术的结果与11例先前接受手术切除的患者（1985 - 1995年）的数据进行比较。
我们在43例（95.6%）患者中实现了GTR，2例（4.4%）患者实现了近全切除；无进展生存率为53.8%，总生存率为64%。
我们新颖的手术技术极大地改善了患有CPA室管膜瘤的儿科患者的中枢神经系统功能和生存率。
