{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T08:36:56Z","timestamp":1773823016124,"version":"3.50.1"},"reference-count":21,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background: <\/jats:title>\n<jats:p>Tumors of the fourth ventricle are exceedingly rare; however, such lesions are formidable due to the severe postoperative neurological complications (pNCs) which often occur. The adoption of the telovelar approach over the transvermian was created to supposedly mitigate the pNCs; however, there is a lack of sufficient data supporting this theory.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Methods: <\/jats:title>\n<jats:p>Records from six hospitals were reviewed for patients surgically treated for a single tumor within the 4<jats:sup>th<\/jats:sup> ventricle from 2016 to 2022. The pNCs which had 10 or more occurrences among the patients were individually assessed as the dependent variable in a binary logistic regression model against covariates which included the surgical approach.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Results: <\/jats:title>\n<jats:p>This study of 67 patients confirms no significant differences in risk for pNCs between the transvermian and telovelar approach. Rather, multivariate analysis identified neurophysiological monitoring (IONM) as a protective factor for postoperative speech and swallowing defects (odds ratio [OR]: 0.076, 95% confidence interval [CI] 0.011\u20130.525). Furthermore, intraoperative external ventricular drainage (EVD) was a protective factor for postoperative gait and focal motor defects (OR: 0.075, 95% CI 0.009\u20130.648) and for postoperative hydrocephalus (OR: 0.020, 95% CI 0.002\u20130.233). A univariate meta-analysis pooling the present study\u2019s patients and an additional 304 patients from the three additional studies in the literature confirms no significant differences in risk between the transvermian and telovelar approach for pNCs.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st4\">\n<jats:title>Conclusion: <\/jats:title>\n<jats:p>Intraoperative adjuncts including IONM and EVD may play a significant role in the postoperative outcome. Despite the present study\u2019s sample size being a major limitation, the findings may provide great value to neurosurgeons given the scarcity of the current literature.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_167_2023","type":"journal-article","created":{"date-parts":[[2023,4,7]],"date-time":"2023-04-07T07:07:28Z","timestamp":1680851248000},"page":"124","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Telovelar versus transvermian approach to tumors of the fourth ventricle and their impact on postoperative neurological complications: A multicenter study"],"prefix":"10.25259","volume":"14","author":[{"given":"Samuel D.","family":"Pettersson","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Medical University of Gdansk, Gdansk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Redwan","family":"Jabbar","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical University of Lodz, Lodz, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miros\u0142awa","family":"Pop\u0142awska","sequence":"additional","affiliation":[{"name":"Institute of Medicine, Opole University, Opole, Poland,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aleksander","family":"Och","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Medical University of Gdansk, Gdansk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eduardo","family":"Orrego-Gonzalez","sequence":"additional","affiliation":[{"name":"Division of Neurosurgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, United States,"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomasz","family":"Klepinowski","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Pomeranian Medical University, 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