Curative analysis of different surgical treatments for non-solid hemangioblastoma in posterior cranial fossa

Abstract

Objective  The article analyzed the curative effect of different surgical treatments for non-solid hemangioblastoma in posterior cranial fossa to explore reasonable operation method.  Methods  Clinical data of 61 patients with non-solid hemangioblastoma who underwent surgeries in Tianjin Huanhu Hospital during July 2007 and June 2014 were retrospectively analyzed. According to surgical approaches and the situation of foramen magnum and atlas, these patients were divided into 5 groups: midline approach opening foramen magnum and atlas (Group A), midline approach without opening foramen magnum and atlas (Group B), paramedian approach opening foramen magnum and atlas (Group C), paramedian approach without opening foramen magnum and atlas (Group D), retrosigmoid approach (Group E). By collecting clinical symptoms, imaging findings, surgical records and postoperative complications, the surgical results and occurrence of postoperative complications were summarized and reasonable operation method was discussed.  Results  Among 61 patients, total resection was achieved in 56 cases (91.80%), and partial resection was achieved in 5 cases (8.20% ). The postoperative remission rate of 43 cases with hydrocephalus was 79.07% (34/43). Intracranial infection was the most common postoperative complication, accounting for 22.95% (14/61). There was significant difference in occurrence rate of intracranial infection among 4 subgroups: opening or not opening the foramen magnum and atlas with or without restoring bone flap (Z = 16.269, P = 0.001). In the subgroup of not opening foramen magnum and atlas with restoring bone flap, the infection rate, which accounted for 6.90% (2/29), was the lowest.  Conclusions  The surgical treatment options for non-solid hemangioblastoma in posterior fossa should be done according to patients' condition, and performed by a professional group. If conditions allow, not to open the foramen magnum and atlas, as well as intraoperative restoring bone flap should be chosen as far as possible, so as to reduce the occurrence of postoperative complications.

DOI: 10.3969/j.issn.1672-6731.2015.06.013