​Chiari Malformation Surgery and Treatment

There are different types of Chiari malformations. Doctors at the UPMC Chiari Center will consider each one separately when deciding on the best treatment for you.

The goals of Chiari malformation treatment include:

  • Reducing pressure on the nerve tissue
  • Creating normal flow of cerebrospinal fluid around and behind the cerebellum

Malformations that cause no symptoms should be left alone and do not require surgery.

Although medications may ease the pain associated with a Chiari malformation, surgery is the only treatment that will correct functional disturbances or stop the progression of damage.

Surgery to Reduce Pressure

The most common operation for Chiari malformation in adults — called posterior fossa decompression — involves removing a small section of bone in the back of the skull.

Neurosurgeons open the covering of the brain (the dura) and sew a patch in place to enlarge the covering. This provides more room for the brain and relieves the pressure.

Surgeons treat pediatric Chiari malformation similarly, although the decompression is usually followed at lower levels to decompress the spinal canal.

The Endoscopic Endonasal Approach

​When Chiari malformation is associated with ventral compression of the brainstem by some other anomaly — such as basilar invagination — then surgeons may use the Endoscopic Endonasal Approach (EEA).

This innovative, minimally invasive technique uses the nose and nasal cavities as natural corridors to access the malformation.

EEA can offer the benefits of:

  • No incisions to heal
  • No disfigurement
  • Faster recovery time than with traditional, open surgery

 

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