P14.18.A POSTERIOR CRANIAL FOSSA RECONSTRUCTION TECHNIQUE TO REDUCE POSTOPERATIVE PSEUDOMENINGOCELE IN PEDIATRIC PATIENTS OF POSTERIOR FOSSA TUMOR SURGERY WITH SUBOCCIPITAL MIDLINE APPROACH

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Abstract BACKGROUND Pediatric patients undergoing tumor resection through a suboccipital midline approach carry a high risk of pseudomeningocele and cerebrospinal fluid (CSF) leakage. We describe our experience of eliminating the dead space introduced by the original surgical incision compared to traditional methods to reduce this risk. MATERIAL AND METHODS The data of children who underwent tumor resection with a suboccipital midline approach were retrospectively analyzed. The patients were divided into a traditional group and an improved group according to whether the new technique proposed in this study was used. Complications such as pseudomeningocele, meningitis, and hydrocephalus during hospitalization and follow-up were retrospectively analyzed. Univariate and multivariate logistic regression analyses were used to explore the relationship between the use of new technology and postoperative complications. All patients were followed up regularly for 2 weeks, 1 month, and 3 months after surgery. RESULTS Our retrospective study identified 111 eligible pediatric patients who underwent tumor resection with a suboccipital midline approach and showed that postoperative complications were lower in the improved group than in the traditional group (39.1% vs 55.4%). This difference is particularly marked in the case of PMC (10.9% vs 27.7%, OR 0.26, p = 0.027). The use of new technology was a protective factor for postoperative PMC, while the use of new technology did not significantly lower the occurrence rate of meningitis and postoperative hydrocephalus. The pathological type of tumor may be related to the occurrence of postoperative PMC, but there was no significant statistical difference (p=0.083). CONCLUSION Compared with traditional surgery, eliminating the dead space caused by the primary surgical incision is a simple and feasible technique, which can reduce the incidence of pseudomeningocele.

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