Endoscopic telovelar approach to the fourth ventricle: Anatomic study

Antonio Di Ieva*, Mika Komatsu, Fuminari Komatsu, Manfred Tschabitscher

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

20 Citations (Scopus)


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.

Original languageEnglish
Pages (from-to)341-348
Number of pages8
JournalNeurosurgical Review
Issue number3
Publication statusPublished - Jul 2012
Externally publishedYes


  • Anatomy
  • Cerebellomedullary fissure
  • Endoscopy
  • Exoscopy
  • Fourth ventricle
  • Telovelar approach


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