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  • Craniometric Lines Aiming Positioning in the Supracerebellar Infratentorial Approach

    Final Number:

    Juan Manuel Revuelta Barbero MD; Anwar Saab Mazzei; Sofia Santiño Gómez; Carlos Cotúa Quintero; Xavier Santander Espinoza; Raquel Gutiérrez González; Avelino Parajón Díaz

    Study Design:

    Subject Category:

    Meeting: Congress of Neurological Surgeons 2016 Annual Meeting

    Introduction: Although pineal region tumors represent a small portion of the intracranial neoplasic lesions, they are frequently approached via supracerebellar infratentorial craniotomy.

    Methods: Mid sagittal plane MR and CT images will be fused using a free software (Osirix viewer). 25 control adult specimens will be included. The following items will be analyzed: 1- Points: Corpus callosum splenium, external occipital protuberance (EOP), horizontal mandibular ramus (HMR) 2- Alpha angle: Splenium - EOP and EOP - HMR 3- Alpha angle Bisector (AB) 4- Beta angle: AB and Splenium - EOP 5- A distance: From Splenium to intersection with EOP-HMR line 6- B distance: Between intersection of A distance-AB and A distance-EOP-HMR

    Results: Alpha and beta angles will be measured, as well as A-B distance, to know their standard deviation related to age and gender. According to the results, the cervical flexion degree and the distance sternal manubruim - mentum, will be validated in order to determine their optimal values to achieve a direct access, good visibility and complications avoidance.

    Conclusions: The supracerebellar infratentorial approach is widely used in the treatment of the pineal region tumors, and represents a safe approach. The positioning of the patient in the operating table is of paramount importance and objective values are proposed to achieve it optimally.

    Patient Care: - Improve patient positioning for a direct approach, avoiding vascular lesions and reduce positioning timing as a fundamental part of surgery. - Avoid iatrogenic spine lesions during cervical manipulation.

    Learning Objectives: The aim of this study is to choose the optimal cervical flexion that can allow a direct and safe access for this approach.


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