Clinical efficacy of cerebellar tonsillectomy vs.simple posterior cranial fossa decompression with expanded dura mater repair in the treatment of Chiari malformation type Ⅰ
DONG Yongjun
SONG Feixia
MA Guofo
ZHANG Chen
TIAN Lei
GAO Leilei
TIAN Dezhou
CHEN Xiaodong
YANG Jun
QIANG Jingling
GAO Feng
Abstract：Objective To compare the clinical efficacy of cerebellar tonsillectomy and posterior cranial fossa decompression with expanded dura mater repair in the treatment of patients with Chiari malformation type Ⅰ(CMI).Methods A retrospective analysis was conducted on the clinical data of patients with Chiari malformation type Ⅰ who were admitted to the Neurosurgery Departments of Third Hospital of Peking University-Yan'an Branch(Yan'an Central Hospital),Affiliated Hospital of Yan'an University,and Third Hospital of Peking University and underwent surgical treatment from January 2013 to October 2022.A total of 64 patients were included in this study,who were divided into the cerebellar tonsillectomy group(Group A=38 cases)and the posterior cranial fossa decompression with expanded dura mater repair group(Group B=26 cases)based on the surgical methods.Among the 64 patients,20(31.25％)were male and the age ranged from 34 to 62 years;44(68.75％)were female and the age ranged from 42 to 69 years.The indicators such as operation time,intraoperative blood loss,postoperative complications,and prognosis were recorded.Results Preoperative imaging showed that the number of spinal syrinxes in both groups was 31(81.58％)and 22(84.62％)respectively,with no statistical difference between the two groups(P=0.75).The most common clinical manifestations were limb numbness(73.68％vs 65.38％),followed by shoulder-neck and limb pain(65.79％vs 57.69％)and pain and temperature sensation disorders(47.37％vs 42.31％).The postoperative relief rates of the two groups were similar(73.68％vs 65.38％),and the difference did not reach statistical significance(P=0.58).The common postoperative complications were central nervous system infection and cerebrospinal fluid leakage.The average operation time of Group A patients was 148.64 minutes,with about 80 ml of intraoperative blood loss and an average hospital stay of 10 days;the average operation time of Group B was 132 minutes,with about 52 ml of intraoperative blood loss and an average hospital stay of 8 days;there were statistically significant differences in operation time between the two groups(P=0.03).Conclusions Cerebellar tonsillectomy,simple posterior cranial fossa decompression and expanded dura mater repair can all improve the clinical symptoms of CMI.However,the cerebellar tonsillectomy group has more intraoperative time than the control group.Therefore,simple posterior cranial fossa decompression and expanded dura mater repair for the treatment of CMI is recommended.
Keywords：chiari malformation type Ⅰcerebellar tonsillectomyposterior cranial fossa decompressiondural dilatation repairprognosis
Publication Date：2026-02-28
Online Publishing Date：2026-03-13(First online date of this platform, not the publication date of the document)
Pages：5( 72-76 )