J Korean Neurosurg Soc.  2003 Apr;33(4):413-418.

Surgical Experiences of Tumors in and Surrounding the Pontomedullary Area: Case Report

• Lee DK
• Koh EJ
• Choi HY

Abstract

The authors present our surgical experiences of five patients with tumors in and surrounding the pontomedullary region. The tumors were located in the pons in two patients, cerebellomedullary fissure in two and fourth ventricle extending in bilateral cerebellomedullary fissure in one. After midline suboccipital craniectomy, tumors in the pons were removed via safe entry route such as median sulcus of the 4th ventricle and suprafacial triangle. Tumors in the 4th ventricle extending cerebellomedullary fissure were resected via transvermian and transcerebellomedullary fissure approach. After surgery, the majority of the initial symptoms were relieved to almost normal state except transient facial weakness and nystagmus for 3 months in one, transient exacerbation of the gait disturbance in two. All the five patients showed different histological diagnosis: epidermoid, metastasis, medulloepithelioma, anaplastic astrocytoma, and malignant lympoma, respectively. It is suggested that tumors in and surrounding the pontomedullary area might be removed without significant neurologic sequelae via safe entry route.

Keyword

Cerebellomedullary fissure; Median sulcus; Suprafacial triangle; Safe entry route; Pontomedullary area

MeSH Terms

Astrocytoma
Diagnosis
Fourth Ventricle
Gait
Humans
Neoplasm Metastasis
Neuroectodermal Tumors, Primitive
Pons