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Factors contributing improvement of syringomyelia and surgical outcome in type I Chiari malformation.
Childs Nerv Syst. 2009 Apr; 25(4):453-9.CN

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.

Authors+Show Affiliations

Department of Pediatric Neurosurgery, Brain Research Institute, College of Medicine, Yonsei University, Seoul, South Korea.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19057907

Citation

Park, Young Seok, et al. "Factors Contributing Improvement of Syringomyelia and Surgical Outcome in Type I Chiari Malformation." Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery, vol. 25, no. 4, 2009, pp. 453-9.
Park YS, Kim DS, Shim KW, et al. Factors contributing improvement of syringomyelia and surgical outcome in type I Chiari malformation. Childs Nerv Syst. 2009;25(4):453-9.
Park, Y. S., Kim, D. S., Shim, K. W., Kim, J. H., & Choi, J. U. (2009). Factors contributing improvement of syringomyelia and surgical outcome in type I Chiari malformation. Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery, 25(4), 453-9. https://doi.org/10.1007/s00381-008-0763-9
Park YS, et al. Factors Contributing Improvement of Syringomyelia and Surgical Outcome in Type I Chiari Malformation. Childs Nerv Syst. 2009;25(4):453-9. PubMed PMID: 19057907.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Factors contributing improvement of syringomyelia and surgical outcome in type I Chiari malformation. AU - Park,Young Seok, AU - Kim,Dong-Seok, AU - Shim,Kyu-Won, AU - Kim,Jung-Hee, AU - Choi,Joong-Uhn, Y1 - 2008/12/05/ PY - 2008/10/05/received PY - 2008/12/6/pubmed PY - 2009/6/12/medline PY - 2008/12/6/entrez SP - 453 EP - 9 JF - Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery JO - Childs Nerv Syst VL - 25 IS - 4 N2 - 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. SN - 1433-0350 UR - https://www.unboundmedicine.com/medline/citation/19057907/Factors_contributing_improvement_of_syringomyelia_and_surgical_outcome_in_type_I_Chiari_malformation_ L2 - https://doi.org/10.1007/s00381-008-0763-9 DB - PRIME DP - Unbound Medicine ER -