[Surgical treatment of tumors in the tentorial region]

On the basis of findings and results obtained in the treatment of 509 patients affected with tumours growing into the tentorial slit (Burdenko Institute, Moscow) the considerably improved surgical possibilities are discussed. Only 17 patients had to be excluded from the operation because of their bad general condition. Ways of access are: supratentorially with transecting of the tentorium, infratentorially with exposure of the tentorium, and the combined infra- and supratentorial method with separation of the tentorium. Subdivision of the access paths according to location and kind of the tumours. Total removal of the tumour in 43.3 per cent, partial removal of the tumour in 41 per cent, palliative intervention in 15.7 per cent of the cases. Relapse operations in 26.2 per cent (mainly trigeminal neurinomas, tentorial meningiomas, cerebellopontine angle meningiomas and cerebellar astrocytomas). After-observation for a period of up to 12 years. The longest survivae times were found for tumours with an anterior-laterial position in the tentorial slit.