第四脑室肿瘤是小儿神经外科中常见的病理情况。关于永久性神经功能缺陷、长期功能后果、小脑无言症(CM)、切除程度(EOR)和肿瘤学结局的预测因素的数据十分有限。我们试图通过对我们机构队列的分析来对这个问题做出贡献。回顾性单中心研究中，对2006年至2021年期间(15年)行第四脑室肿瘤原发性手术切除的≤19岁患者进行患者研究。分析的预测因变量包括年龄、性别、手术方式、解剖学模式、肿瘤分级、EOR、肿瘤体积和其他相关因素。纳入了106例患者(男性64例，平均年龄7.3岁)。永久性神经功能缺陷的发生率为24.2％；侧向肿瘤扩展(p=0.036)和肿瘤体积大于38 cm3(p=0.020)是显著的预测因素。缺陷的存在是降低Lansky评分(小于90)的唯一显著预测因素(p=0.005)。CM在20.8％的患者中发生，受小脑母细胞瘤组织学(p=0.011)、侧向肿瘤扩展(p=0.017)和男性性别(p=0.021)的影响。在发生CM方面，横金字桥入路和后颅凹入路之间没有显著差异(p=0.478)。没有找到EOR的显著预测因素。EOR对低级别和高级别肿瘤的总体存活率均无显著预测作用；然而，与近全切除或次全切除相比，肿瘤的总割除(完全切除，GTR)对预防肿瘤复发有保护作用(p<0.001)。此外，年龄较大的患者(≥7.0岁)的存活率更高(p=0.019)。术后并发症的总体发生率仍然较高，由于定位难度高。年龄较大的患者(>7岁)预后和结果更好。在可行和安全的情况下尽量达到GTR对于防止肿瘤复发至关重要。CM在小脑母细胞瘤患者和经卢氏孔扩展的肿瘤患者中更常见。后颅凹入路使用了安全且解剖学上节省的通路；然而，在我们的系列研究中，并未发现与CM发病率和神经系统后遗症发生率降低相关的情况，这表明每个案例都应进行个体评估。© 2023. 作者授予Springer-Verlag GmbH Austria独有的许可权，Springer Nature的一部分。

Tumors of the fourth ventricle are frequently treated pathologies in pediatric neurosurgery. Data regarding predictors for permanent neurological deficits, long-term functional outcomes, cerebellar mutism (CM), the extent of resection (EOR), and oncological outcomes are scarce. We attempt to contribute to this topic with an analysis of our institutional cohort.A retrospective single-center study of patients aged ≤ 19 years who underwent primary surgical resection of a fourth ventricular tumor over a 15-year period (2006-2021). Predictors analyzed included age, gender, surgical approach, anatomical pattern, tumor grade, EOR, tumor volume, and others as appropriate.One hundred six patients were included (64 males, mean age 7.3 years). The rate of permanent neurological deficit was 24.2%; lateral tumor extension (p = 0.036) and tumor volume greater than 38 cm3 (p = 0.020) were significant predictors. The presence of a deficit was the only significant predictor of reduced (less than 90) Lansky score (p = 0.005). CM occurred in 20.8% of patients and was influenced by medulloblastoma histology (p = 0.011), lateral tumor extension (p = 0.017), and male gender (p = 0.021). No significant difference between the transvermian and telovelar approach in the development of CM was detected (p = 0.478). No significant predictor was found for the EOR. EOR was not found to be a significant predictor of overall survival for both low-grade and high-grade tumors; however, gross total resection (GTR) was protective against tumor recurrence compared to near-total or subtotal resection (p < 0.001). In addition, survival was found to be better in older patients (≥ 7.0 years, p = 0.019).The overall rate of postoperative complications remains high due to the eloquent localization. Older patients (> 7 years) have been found to have better outcomes and prognosis. Achieving GTR whenever feasible and safe has been shown to be critical for tumor recurrence. CM was more common in patients with medulloblastoma and in patients with tumors extending through the foramen of Luschka. The telovelar approach uses a safe and anatomically sparing corridor; however, it has not been associated with a lower incidence of CM and neurological sequelae in our series, showing that each case should be assessed on an individual basis.© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Austria, part of Springer Nature.