Format

Send to:

Choose Destination
See comment in PubMed Commons below
Childs Nerv Syst. 2009 Apr;25(4):453-9. doi: 10.1007/s00381-008-0763-9. Epub 2008 Dec 5.

Factors contributing improvement of syringomyelia and surgical outcome in type I Chiari malformation.

Author information

  • 1Department of Pediatric Neurosurgery, Brain Research Institute, College of Medicine, Yonsei University, Seoul, South Korea.

Erratum in

  • Childs Nerv Syst. 2009 Apr;25(4):513.

Abstract

OBJECTIVE:

The aim of our study was to compare pre- and postoperative radiologic data of posterior fossa and the improvement of syringomyelia after posterior fossa decompression (PFD) with and without tonsillar management in Chiari type capital I, Ukrainian malformation (CM-I).

MATERIAL AND METHODS:

A retrospective analysis was made of all patients who underwent PFD between Oct 1991 and March 2007 for CM-I. Fifty-seven patients treated for CM-I at a single institution were included in the study. Patients were divided into two groups according to the procedures used during their PFD: PFD vs. PFD with tonsillar management. To determine whether the tonsillar management or changes of posterior fossa volume relate with surgical outcome, we measure posterior fossa size and syringomyelia pre- and postoperatively using magnetic resonance imaging.

RESULTS:

Forty patients (70.2%) received PFD and 17 patients (29.8%) received PFD with tonsillar management. The length of syringomyelia affected improvement of syringomyelia (alteration rate, A-rate). Clinical symptoms, craniectomy size, syringomyelia type, and the surgeon's specialty did not affect A-rate. Tonsillar management has no significant effect on improvement of syringomyelia. Four patients need repeated surgery due to recurrence.

CONCLUSION:

We have shown that tonsillar management do not lead to improve A-rate, and the radiologic changes of posterior fossa volume do not relate with radiologic improvement of syringomyelia. PFD without tonsillar management is sufficient to improve syringomyelia. The longer syrinx, the more A-rate improve in our study. However, a wider craniectomy is unrelated to A-rate. In cases of recurrent patients, we obtained good results with tonsillar management or syringosubarachnoid shunt.

PMID:
19057907
[PubMed - indexed for MEDLINE]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Springer
    Loading ...
    Write to the Help Desk