Coagulation of herniated cerebellar tonsils for cerebrospinal fluid pathway restoration

In the past, many different surgical techniques have been proposed for treatment of the Chiari type I malformation. Despite the different technical considerations, in general, the treatment objectives have shared certain features: to prevent/ameliorate tonsillar crowding and to restore normal circulation of cerebrospinal fluid at the foramen magnum. We report a simple technique of coagulation of the herniated cerebellar tonsils in situ to decompress adjacent neural structures and to achieve the above-mentioned goals. When compared to the method of tonsillar resection, the procedure described herein affords the following two advantages: it is relatively less time-consuming and is more hemostatic. These two features minimize inflammation-mediated morbidity which may occur during the postoperative period.