Purpose: The choice between sitting and prone position to access the infratentorial space in a suboccipital craniotomy is still a matter of debate. The comparisons in terms of complications and outcome of both positions are scarce, and the pediatric population is indeed more infrequent in these in scientific reviews. In this paper, we assess intraoperative and postoperative complications and neurological outcome in pediatric patients undergoing posterior cranial fossa surgery for pilocytic astrocytoma in sitting and prone position respectively.
Methods: We retrospectively analyzed 30 consecutive patients undergoing surgery for cerebellar pilocytic astrocytoma at the two neurosurgical units referring to the University of Padova Medical School from 1999 to 2017. Preoperative, intraoperative, and postoperative data were retrieved from our medical archives.
Results: The statistical analysis did not show any differences between the two groups in terms of preoperative, intraoperative, and postoperative data. The neurological status at last follow-up was similar in both groups of patients.
Conclusions: Our results suggest that both sitting and prone position can be considered safe in suboccipital craniotomies. Further studies are needed to show if there are possible differences between these positions for other frequent pediatric tumors such as medulloblastomas and ependymomas.
Keywords: Children; Complications; Outcome; Pilocytic astrocytoma; Surgical positions.
Is the Sitting or the Prone Position Best for Surgery for Posterior Fossa Tumours in Children?GA Orliaguet et al. Paediatr Anaesth 11 (5), 541-7. PMID 11696117.PFT surgery in the sitting position in children is not associated with an increased number or severity of perioperative complications, while the postoperative course appe …
Magnetic Resonance Imaging Features of Common Posterior Fossa Brain Tumors in Children: A Preliminary Vietnamese StudyNM Duc et al. Open Access Maced J Med Sci 7 (15), 2413-2418. PMID 31666838.MRI plays a crucial role in demonstrating the features of posterior fossa brain tumours for appropriate diagnosis of medulloblastomas, ependymomas, and pilocytic astrocyt …
Comparison of Outcomes Following Complex Posterior Fossa Surgery Performed in the Sitting Versus Lateral PositionS Spektor et al. J Clin Neurosci 22 (4), 705-12. PMID 25752232.The sitting position during surgery is thought to provide important advantages, yet it remains controversial. We compared surgical and neurological outcomes for patients …
Pediatric Glial TumorsKJ Cohen et al. Curr Treat Options Oncol 2 (6), 529-36. PMID 12057098. - ReviewGlial neoplasms in children comprise many heterogeneous tumors that include pilocytic and fibrillary astrocytomas, ependymomas, and the diffuse intrinsic pontine gliomas. …
Complications Related to Sitting Position During Pediatric Neurosurgery: An Institutional Experience and Review of LiteratureP Gupta et al. Neurol India 66 (1), 217-222. PMID 29322987. - ReviewThis study observed a lesser incidence of VAE and associated complications. Tension pneumocephalus was managed successfully without any adverse outcome. Hence, it is beli …