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Dokuz Eylül Üniversitesi Tıp Fakültesi Nöroşirürji Anabilim Dalı, İzmir Craniovertebral decompression (CV D) and construction of cisterna magna with dural graft is the currently accepted method for treatment of syringomyelia associated with Chiari I malformation. It has been reported that this method provided a high rate of success according to the physiopathological experiences. However; persistence of the syrinx cavity was observed in some cases related to the complications of this method. On the other hand this siruation was seen in some cases despite the appropriate practice of CVD. As a result of these observations; modifications of the method and/ or addition of new procedures was being discussed in recent papers. At the long term follow up of our patients, successful results were obtained in the first three cases and the width of syrinx cavities definitely got smaller but persistence of the cavity was observed in fourth case. Considering this case who had a large cavity during the preoperative period, successful result was obtained by adding liquid suction wi th puncture of syrinx cavity to CVD in the treatment of a fifth case who had similar characteristics. In this report, clinical and radiological characteristics of our cases were presented and effectiveness of CVD treatment was discussed under the view of current literature. Anahtar Kelimeler : Chiari I malformation, syringomyelia, craniovertebral decompression