The symposium is co-organised by The Ann Conroy Trust, in association with Aesculap Academia.
The Ann Conroy Trust is Registered Charity No: 1165808.
We provide Support, Education and Research for patients living with Chiari Malformation, Syringomyelia and associated conditions.
F6 Minimally Invasive Sub-pial Tonsillectomy (MIST) and reconstruction of the cisterna magna in the treatment of Chiari malformation type 1 with syringomyelia..
Lou Y, Li H, Jin Y, Liu L.
Minimally Invasive Sub-pial Tonsillectomy (MIST) and reconstruction of the cisterna magna, resolves the tonsillar herniation and reconstitutes the cisterna magna, which in turn restores cerebrospinal fluid circulation. Intraoperative ultrasound is used. In this study we assess the outcomes of the procedure in the management of Chiari malformation type 1 with syringomyelia.
Methods. Between January 2014 and June 2015, 130 patients meet the inclusion criteria. The Chicago Chiari Outcome Scale (CCOS) was used to assess clinical outcomes. Post-operative MRI at 6 months assessed the change in the syrinx. We compared our cohort with a historical control group of 167 cases and a literature group of 378 cases, using the Fisher exact test (significance level: p<0.05)
In our group of 130 cases, 127 patients (98%) had good post-operative CCOS (≥11), whereas in 3 cases the score was poor (4-10). The relevant rate of improvement in the historical control group of 167 patients was 82％, which is significantly lower (p=0.032). The MRI at 6 months post-operatively showed reduction or complete resolution in all 130 cases.
The Minimally Invasive Sub-pial Tonsillectomy and reconstruction of the cisterna magna in patients with Chiari malformation type 1 and syringomyelia has very good clinical and radiological outcomes compared with traditional surgery. It is associated with a low complication rate and emphasizes the importance of reconstructing normal posterior fossa anatomy.