INDIVIDUAL PLANNING OF SURGICAL APPROACHES IN SURGERY OF POSTERIOR CRANIAL FOSSA TUMORS

Abstract

To optimize surgical interventions for tumors of the posterior cranial fossa (PCF), a method of individualized planning of surgical approaches was developed, taking into account the histological structure and tumor localization in various forms of the bone-dural framework. An analysis was conducted of 93 computed tomography (CT) and 48 magnetic resonance imaging (MRI) scans, as well as 72 CT and MR angiograms and sinusograms from patients with PCF tumors of varying locations, using a system of bony landmarks and projection lines. Variants of PCF anatomy were identified, and features of displacement of brain structures and neurovascular formations were analyzed depending on the tumor’s location and the shape of the bone-dural framework. Based on the data obtained, an algorithm was developed for planning and calculating access parameters according to the individual topography of the tumor. The use of this individualized approach in 67 patients with PCF tumors improved surgical accuracy, reduced access-related trauma, shortened operation time, and decreased the frequency and severity of postoperative complications.