Clinical Efficacy of Endoscopic Infratentorial Supracerebellar Approach for Pineal Region Tumors: A Retrospective Case-Control Study

Figure 3

Clinical data of patients A–C. Preoperative head MR1 enhanced scans showed a circular space-occupying lesion in the pineal region in axial (a), coronal (b), and sagittal (c) views (arrows). (d) The patient’s surgical position during the operation was supported by a pneumatic arm, the head of the operating bed was raised 15°, and the neck was flexed to the left by about 15°. (e) The transverse sinus was exposed during the operation. (f) The tumor was gradually revealed along the infratentorial and superior cerebellar vermis spaces, and the arachnoid membrane of the quadrigeminal cistern was explored. (g) Intracapsular decompression was performed to remove the tumor. (h) After the tumor was completely removed, the third ventricle was fully opened, and the opening of the midbrain aqueduct was seen to be unobstructed. MR scan of the skull showed that all the lesions in the pineal region were excised. (L) Postoperative pathological results suggested (pineal region) germ cell tumors (HE staining  ×  200).

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