title: Endoscopic port surgery for resection of lesions of the cerebellar peduncles: technical note.
abstract: BACKGROUND
  Mass lesions of the inferior, middle, and superior cerebellar peduncles (cerebellar peduncle complex [CPC]) present numerous surgical pitfalls when resection or debulking is warranted. Success has been achieved through multiple approaches, but complications can be severe.
  
  
  OBJECTIVE
  To report the surgical technique for and clinical results of the treatment of lesions in the CPC with an endoscopic port via a lateral transcerebellar corridor.
  
  
  METHODS
  Three patients underwent resection of intrinsic lesions of the CPC via a lateral transcerebellar approach with an endoscopic port. Deployment of the port was performed with frameless image-guided placement into the area of interest. Resection was performed using bimanual microsurgical technique under parallel endoscopic visualization.
  
  
  RESULTS
  Three patients 43, 27, and 13 years of age underwent successful resection of lesion in the CPC. Histopathological diagnosis consisted of cavernous malformation, glioblastoma multiforme, and a juvenile pilocytic astrocytoma. All had complete gross total resection except for the patient with a high-grade glioma. Clinically, all had excellent outcomes, with 1 patient suffering postoperative facial palsy after resection of her high-grade glioma.
  
  
  CONCLUSIONS
  The lateral transcerebellar approach to the CPC with an endoscopic port may be a feasible alternative to standard microsurgical resection in such difficult cases. Careful patient selection is critical to identify those who may be suitable for endoscopic port surgery on the basis of clinical, radiographic, and anatomical considerations.
authors.affiliation: Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15213, USA.
authors.forename: Pawel G
authors.initials: PG
authors.lastname: Ochalski
authors.forename: Juan C
authors.initials: JC
authors.lastname: Fernandez-Miranda
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Prevedello
authors.forename: Ian F
authors.initials: IF
authors.lastname: Pollack
authors.forename: Johnathan A
authors.initials: JA
authors.lastname: Engh
mesh_terms: D000293:Adolescent; D000328:Adult; D002526:Cerebellar Diseases / Q000473:pathology* / Q000601:surgery*; D002531:Cerebellum / Q000473:pathology / Q000601:surgery; D004724:Endoscopy / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D038361:Neuronavigation / Q000379:methods*