Neuroendoscopic Surgical Treatment of Cerebellar Vermis Tumors in Pediatric Patients : Case Series

To investigate the utility and experience of neuroendoscopy in the resection of cerebellar vermis tumors. Retrospective analysis was conducted on the clinical data of cerebellar vermis tumors treated with the German STORZ neuroendoscope within the Department of Neurosurgery at Guizhou Provincial People's Hospital and Guizhou Hospital of Shanghai Children's Center from January 2021 to January 2024. Among the 18 patients, total resection was achieved in 16 cases, subtotal resection in 1 case, and biopsy in 1 case. Postoperative pathological analysis revealed 9 cases of medulloblastoma, 3 cases of ependymoma, and 5 cases of astrocytoma (comprising 2 WHO grade I, 2 grade II, and 1 grade III), along with 1 case of a benign cerebellar lesion. Postoperative complications included perioperative malignant arrhythmia in 1 case, cerebellar mutism in 4 cases, and ataxia in 13 cases. During the 1-36 months follow-up period, communicating hydrocephalus was observed in 2 cases. Improvement in hydrocephalus was noted at 2 months and 6 months postoperatively following ventriculoperitoneal shunt placement. Cerebellar mutism showed significant improvement postoperatively, with an average recovery time of 21 days (range: 81 ±15 days), while ataxia improved within an average of 50 days (range: 70 ±26 days) after surgery. The latest follow-up revealed tumor recurrence in 3 patients. Neuroendoscopic surgical resection of cerebellar vermis tumors, when performed by experienced operators, can effectively achieve the necessary surgical exposure and offer an alternative to traditional microscopy.