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ANATOMICAL RISK FACTORS FOR THE COMPLICATED POSTOPERATIVE PERIOD IN THE SURGERY OF EXTRACEREBRAL TUMORS OF THE POSTERIOR CRANIAL FOSSA

https://doi.org/10.20340/mv-mn.2022.30(3).654

Abstract

Tumors of the base of the posterior cranial fossa are among the most difficult for surgical treatment in neurosurgery. Numerous studies are being conducted on the factors that determine clinical manifestations and treatment outcomes. The aim of the study was to study the linear and angular parameters of the posterior cranial fossa in patients with extracerebral neoplasms and to evaluate their effect on the results of surgical treatment. Craniometric study of linear and angular parameters of the posterior cranial fossa was performed in 115 patients with sub-tentorial extracerebral tumors. A computer program was used to determine the longitudinal, transverse and height diameters of the head, the length, width and height of the posterior cranial fossa, the sagittal diameter of the foramen magnum, the length of the clivus, the length of the posterior part of the skull base, the basilar angle, the Boogard’s angle, the posterior angle of the base of the skull, angle of the cerebellar mantle, angle of inclination of the clivus, angle of inclination of the scales of the occipital bone and angle of convergence of the pyramids of the temporal bones. These parameters were determined on magnetic resonance tomograms in the sagittal projection on the median section and in the axial projection, on the section passing at the level of the internal auditory canals. The main group consisted of 15 patients who developed vascular complications after surgery, the second comparison group included 100 patients with uncomplicated postoperative course. The predominant head shapes according to the transverse-longitudinal index in both groups were brachycephalic (53.3 and 54%, respectively). There was no acrocephaly (high and narrow head forms) among patients with complications, while in the control group this type was registered in 12% of cases. Certain craniometric prerequisites for a complicated course of the postoperative period have been identified, allowing a more selective approach to the tactics of treating these patients. The risk group includes patients with large values ​​of the basilar angle and the angle of inclination of the scales of the occipital bone, having a narrower and elongated shape of the posterior cranial fossa.

About the Authors

Valerian G. Nikolaev
Professor Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk
Russian Federation

Professor, Doctor of Medical Sciences, Professor of the Department of Human Anatomy


Competing Interests:

The author declares that he have no conflicts of interest in the planning, implementation, financing and use of the results of this study



Pavel G. Rudenko
Professor Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk Regional Clinical Hospital, Krasnoyarsk
Russian Federation

Candidate of Medical Sciences, Assistant of the Department of Traumatology, Orthopedics and Neurosurgery with a Postgraduate Course of the Professor Voyno-Yasenetsky Krasnoyarsk State Medical University, Neurosurgeon of the First Neurosurgical Department of the Krasnoyarsk Regional Clinical Hospital


Competing Interests:

The author declares that he have no conflicts of interest in the planning, implementation, financing and use of the results of this study



Pavel G. Shnyakin
Professor Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk Regional Clinical Hospital, Krasnoyarsk
Russian Federation

Doctor of Medical Sciences, Head of the Department of Traumatology, Orthopedics and Neurosurgery with a Postgraduate Course of the Professor Voyno-Yasenetsky Krasnoyarsk State Medical University, Deputy Head of the Regional Vascular Center of the Krasnoyarsk Regional Clinical Hospital


Competing Interests:

The author declares that he have no conflicts of interest in the planning, implementation, financing and use of the results of this study



Svetlana N. Derevtsova
Professor Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk
Russian Federation

Docent, Doctor of Medical Sciences, Professor of the Department of Human Anatomy


Competing Interests:

The author declares that she have no conflicts of interest in the planning, implementation, financing and use of the results of this study



Aleksey V. Trubkin
Professor Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk Regional Clinical Hospital, Krasnoyarsk
Russian Federation

Post-graduate Student of the Department of Traumatology, Orthopedics and Neurosurgery with a Postgraduate Course of the Professor Voyno-Yasenetsky Krasnoyarsk State Medical University, Neurosurgeon of the Second Neurosurgical Department of the Krasnoyarsk Regional Clinical Hospital


Competing Interests:

The author declares that he have no conflicts of interest in the planning, implementation, financing and use of the results of this study



Ilona E. Milekhina
Professor Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk
Russian Federation

Candidate of Medical Sciences, Associate Professor of the Department of Traumatology, Orthopedics and Neurosurgery with a Postgraduate Course


Competing Interests:

The author declares that she have no conflicts of interest in the planning, implementation, financing and use of the results of this study



Irina S. Usatova
Professor Voyno-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk Regional Clinical Hospital, Krasnoyarsk
Russian Federation

Assistant of the Department of Traumatology, Orthopedics and Neurosurgery with a Postgraduate Course of the Professor Voyno-Yasenetsky Krasnoyarsk State Medical University, Neurosurgeon of the Second Neurosurgical Department of the Krasnoyarsk Regional Clinical Hospital


Competing Interests:

The author declares that she have no conflicts of interest in the planning, implementation, financing and use of the results of this study



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Supplementary files

The authors described some craniometric prerequisites for a complicated course of the postoperative period in patients with extracerebral tumors of the posterior cranial fossa

Review

For citations:


Nikolaev V.G., Rudenko P.G., Shnyakin P.G., Derevtsova S.N., Trubkin A.V., Milekhina I.E., Usatova I.S. ANATOMICAL RISK FACTORS FOR THE COMPLICATED POSTOPERATIVE PERIOD IN THE SURGERY OF EXTRACEREBRAL TUMORS OF THE POSTERIOR CRANIAL FOSSA. Morphological newsletter. 2022;30(3):66-72. (In Russ.) https://doi.org/10.20340/mv-mn.2022.30(3).654

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