The telovelar approach is used in neurosurgery for operations involving the fourth ventricle. In the telovelar approach, access to the fourth ventricle is obtained through the cerebellomedullary fissure without incising the vermis or cerebellar hemisphere1. The approach is performed via a suboccipital craniotomy. The advantage of this approach is the preservation of anatomical structures, thereby reducing the risk of postoperative cerebellar mutism, as well as providing good visualization of the lateral recesses of the fourth ventricle2.
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