The anatomical aspects of a surgical approach through the floor of the fourth ventricle

Acta neurochirurgica
J BoguckiZ Czernicki

Abstract

In 1993 Kyoshima et al. introduced safe entry zones in the region of the 4th ventricle floor: infrafacial triangle and suprafacial triangle. Is it possible to demarcate these zones precisely in every case intra-operatively? A postmortem study of 40 brainstems of patients who had died of non-brain disease was performed to evaluate the degree of individual morphological and morphometrical variability of the 4th ventricle floor. The purpose of this study was to find constant landmarks and distances within the rhomboid fossa region which would help a neurosurgeon to determine safe approach zones through the 4th ventricle floor to brainstem lesions. Several anatomical landmarks-median sulcus, obex, vestibular area, vagal triangle, hypoglossal triangle-were found to be sufficiently visible in all examined brainstems. However, the facial colliculus which is a border structure between the infrafacial and suprafacial safe approach zone was poorly visible in about 37% of the analyzed material. The striae medullares were not found to be good orientation structures as they were not visible in 30% of the material and exhibited individual variability of a high degree in relation to their number and arrangement. In the morphometrical study an...Continue Reading

References

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Citations

Jul 21, 1999·Journal of Neurosurgery·J Bogucki, Z Czernicki
Nov 30, 1999·Journal of Neurosurgery·C StraussR Fahlbusch
May 15, 2007·Neuro-Chirurgie·J ChazalL Sakka
Feb 26, 2016·Neurosurgery·Antonio MeolaJuan C Fernandez-Miranda
May 28, 2005·Neurosurgery·Paolo FerroliGiovanni Broggi
Jul 2, 2014·Neurosurgery·Kaan YagmurluJeffrey A Bennett
Sep 9, 2004·Journal of Neurosurgery·Necmettin TanrioverAlexandre Yasuda
Apr 15, 2017·Journal of Neurosurgery·Sherise D FergusonIan E McCutcheon
Oct 30, 2016·Journal of Neurosurgery·Ali Tayebi MeybodiArnau Benet
Jan 16, 2019·Journal of Neurosurgery·Ridzky Firmansyah HardianKazuhiro Hongo
May 14, 2021·Neurologia Medico-chirurgica·Tatsuya UchidaNobuhito Saito

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