Stereotactic posterior midline approach under direct microscopic view for biopsy of medulla oblongata tumors: technical considerations.

Schlaeppi, Janine-Ai; Andereggen, Lukas; Nowacki, Andreas; Pollo, Claudio (2021). Stereotactic posterior midline approach under direct microscopic view for biopsy of medulla oblongata tumors: technical considerations. Acta neurochirurgica, 163(7), pp. 1965-1968. Springer Vienna 10.1007/s00701-020-04600-6

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BACKGROUND

Open and stereotactic transfrontal or transcerebellar approaches have been used to biopsy brainstem lesions.

METHOD

In this report, a stereotactic posterior and midline approach to the distal medulla oblongata under microscopic view is described. The potential advantages and limitations are discussed, especially bilateral damage of the X nerve nuclei.

CONCLUSION

This approach should be considered for biopsy of distal and posterior lesions. We strongly recommend the use of direct microscopic view to identify the medullary vessels, confirm the midline entry point, and avoid potential shift of the medulla. Further experience is needed to confirm safety and success rate of this approach.

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