title: Endoscopic telovelar approach to the fourth ventricle: anatomic study.
abstract: The telovelar approach allows reliable access to the fourth ventricle and avoids the splitting of the vermis and its associated "posterior vermal split syndrome." Our objective was to describe the endoscopic topographical anatomy of the telovelum approach to the fourth ventricle as accessed by the cerebellomedullary corridor. A series of 20 fresh and fixed injected anatomical specimens were used. The endoscopic equipment consisted of rigid endoscopes with different lens angles, while the extradural step required the use of the microscope and/or the exoscope. All the anatomical landmarks and relationships within the fourth ventricle and the cerebellomedullary fissure were identified by means of the endoscopic microscope/exoscope-assisted telovelar approach. In conclusion, we showed that the endoscope is a valid tool to gain an anatomic understanding of the fourth ventricle reached by means of the telovelar approach.
authors.affiliation: Center for Anatomy and Cell Biology, Department of Systematic Anatomy, Medical University of Vienna, Waehringerstrasse 13, 1090, Vienna, Austria, diieva@hotmail.com.
authors.forename: Antonio
authors.initials: A
authors.lastname: Di Ieva
authors.forename: Mika
authors.initials: M
authors.lastname: Komatsu
authors.forename: Fuminari
authors.initials: F
authors.lastname: Komatsu
authors.forename: Manfred
authors.initials: M
authors.lastname: Tschabitscher
mesh_terms: D002102:Cadaver; D002946:Cisterna Magna / Q000033:anatomy & histology; D003399:Craniotomy / Q000379:methods*; D020546:Fourth Ventricle / Q000033:anatomy & histology* / Q000601:surgery; D006801:Humans; D008866:Microsurgery; D044583:Neuroendoscopy; D019635:Neurosurgical Procedures / Q000379:methods*; D009777:Occipital Bone / Q000033:anatomy & histology / Q000601:surgery