• Br J Neurosurg · Feb 2011

    The presigmoid approach for removal of tumours causing ventral compression of the brainstem. Surgical results and postoperative quality of life.

    • Radek Frič and Per Kristian Eide.
    • Department of Neurosurgery, Oslo University Hospital--Rikshospitalet, Oslo, Norway. radek.fric@rikshospitalet.no
    • Br J Neurosurg. 2011 Feb 1;25(1):86-93.

    ObjectiveTo assess surgical results and quality of life after removal of tumours causing ventral compression of the brainstem using the presigmoid or combined presigmoid/retrosigmoid approaches.MethodsA review of all our patients operated on with removal of tumours causing ventral compression of the brainstem in whom either the presigmoid or combined presigmoid/retrosigmoid approaches were used. Post-operative quality of life was assessed using the SF-36 questionnaire.ResultsA total of 12 consecutive patients were included. A favourable complication profile was found. Cerebrospinal fluid leakage and secondary hydrocephalus were the most frequent complications. Post-operative scores from Karnofsky Performance Scale and ECOG after median 24 months were median 85 and 1, respectively, representing ability to carry on daily activities. Nevertheless, quality of life as assessed subjectively by SF-36 showed significantly reduced values as compared with normative values from Norwegian population.ConclusionsWe found favourable surgical results when using the presigmoid approach alone or combined with the retrosigmoid route for large-sized extrinsic tumours causing ventral compression of the brainstem, both regarding complication profile, degree of tumour removal and functional outcome. However, impact of disease and surgery on quality of life appears to be more significant when assessed subjectively by the patients.

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