臨床神経学および脳神経外科ジャーナル

Prone Positioning for Posterior Fossa Tumors Resection: New Experience in Iraq

Abstract

Haitham H Shareef

Background: Brain tumors are the second most common malignancy in children. About one third occurred in toddlers under the age of 3, and about two-thirds are located in
the posterior fossa. Lesions in the posterior cranial fossa are difficult problems to the neurosurgeon and the anesthetist. Surgical damage to vital medullary centers and air
embolism are the main dangers.

Aim: The neurosurgical default work and training in Iraq is directed toward the sitting position to resect posterior fossa tumor using the classical Sugita skull fixation system. In
this paper we will clarify the use of prone position instead of sitting position to treat such cases.

Material and Methods: A prospective study was done on five cases of pediatric posterior fossa tumors operated on at Al Hussein Teaching Hospital of Nasiriyah using the prone position with the aid of the Mayfield skull fixation system instead of Sugita.

Results: One case diagnosed as medulloblastoma, one case diagnosed as a dermoid cyst, and three cases diagnosed as cerebellar astrocytoma with minimum operative and
post-operative complications. One case developed postoperative cerebellar mutism, one case developed concealed CSF leak which resolved spontaneously.