Microanatomical study of suboccipital median transcerebellomedullary fissure keyhole approach
Xie Hutao
Cheng Hongwei
Li Changyuan
Wu Bingshan
Shan Ming
Mei Zhaojun
Abstract：Objective To microanatomically observe the fourth ventricle and its surrounding structures via the suboccipital median transcerebellomedullary fissure keyhole (STF) approach to provide an anatomical basis for clinical application. Methods The fourth ventricle and its surrounding anatomic structures were dissected, observed and measured for relevant data under operative microscope via STF approach in 10 cadaveric heads (20 sides). Results ①The STF approach can expose the floor of the fourth ventricle, lateral recess, aperture of midbrain aqueduct and lateral brainstem.②The exposure range of the fourth ventricle floor was 37.73±0.77 mm in length, 17.12±0.52 mm in width, and the floor area was 319.70±14.25 mm2.③There were 19-sides posterior inferior cerebellar artery (PICA) from 10 cadaver heads, 1 side PICA was absent. It was founded that bilateral PICA had a large variation in diameter, and the location of the caudal loop also has great variation. Conclusions ①STF approach can expose similar anatomic area as the conventional approach, but the exposure angle is limited and the operative view of deep anatomical structures is not clear enough. ②PICA and cerebellomedullary fissure is closely related to each other, but the running course and distribution of PICA are complex and variable, the surgeon should pay attention to PICA and its branches.
Keywords：approachtranscerebellomedullary fissurekeyholefourth ventricleposterior inferior cerebellar arteriesmicrosurgerydissection
Publication Date：2016-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 555-558 )