Biportal Endoscopic Management of Third Ventricle Tumors in Patients with Occlusive Hydrocephalus: Technical Note

Vetö, F.; Horváth, Zoltán; Dóczi, Tamás

doi:10.1097/00006123-199704000-00048

Cited by 49 publications

(27 citation statements)

References 15 publications

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“…31,32 We have found this helpful only in two of our 87 cases, and certainly would not recommend it as a routine and share the reservations of Drake 33 especially as the incidence of post-operative epilepsy directly attributable to neuroendoscopy has not yet been established. In our series, four patients experienced seizures for the rst time following neuroendoscopic tumour surgery.…”

Section: Technical Aspectsmentioning

confidence: 90%

The role of neuroendoscopy in the management of brain tumours

Macarthur¹,

Buxton²,

Punt³

et al. 2002

British Journal of Neurosurgery

101

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Neuroendoscopy is increasingly used in the management of brain tumours and tumour related hydrocephalus and this study reviews the efficacy of neuroendoscopic interventions in this unit in patients with brain tumours. A series of 87 neuroendoscopic operations carried out in 77 patients with brain tumours over a 6-year period is reported. The age range of the patients was from 5 months to 70 years (median 13 years). In 56 cases (64%) presentation was with a newly-diagnosed tumour and hydrocephalus. The majority of the remaining patients had varying degrees of worsening hydrocephalus on the background of a previously diagnosed tumour. Neuroendoscopic third ventriculostomy (NTV) was successful in relieving hydrocephalus in the short term in 63/66 cases (95%) and in the longer term in 55/66 cases (83%). Neuroendoscopic tumour biopsies were successful in providing a tissue diagnosis in 17/28 cases (61%) and four extensive and three partial resections of tumour were carried out. There were two deaths within 30 days of the procedure with only one of these, secondary to intraventricular haemorrhage, directly related to neuroendoscopy. Few significant complications were noted otherwise. For selected intraventricular and paraventricular tumours neuroendoscopy offers the opportunity to combine relief of hydrocephalus with tumour biopsy and sampling of CSF in a single procedure.

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Section: Technical Aspectsmentioning

confidence: 90%

The role of neuroendoscopy in the management of brain tumours

Macarthur¹,

Buxton²,

Punt³

et al. 2002

British Journal of Neurosurgery

101

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“…Furthermore, the best trajectory for aqueductal stenting usually is not ideal for ETV, i.e. for combined procedures through one burr hole with a rigid endoscope, increasing the risk of fornix damage [29]. (4) ETV and aqueductoplasty without shunt placement is only justified, if the hydrocephalus in DWM is considered to be a noncommunicating one, which is not fully proven yet [10].…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Transtentorial Ventriculocystostomy and Cystoventriculoperitoneal Shunt in a Neonate with Dandy-Walker Malformation and Associated Aqueductal Obstruction

et al. 2005

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Objective: Shunting of the lateral ventricle and the posterior fossa cyst is the advocated surgical therapy for children with Dandy-Walker malformation (DWM) and associated aqueductal obstruction. The high rate of complications of combined shunting stimulated the authors to search for an alternative surgical solution. Clinical Presentation/Intervention: After transtentorial endoscopic ventriculocystostomy, a cystoventricular catheter, connected to a peritoneal shunt, was placed in a neonate with DWM and associated aqueductal obstruction. Immediately prior to ventriculocystostomy, the presence of a blocked third ventricular outflow was reconfirmed by contrast medium injection. Neuronavigation was required to define the surgical path from the lateral ventricle through the tentorium and the overlying small rim of brain parenchyma into the posterior fossa cyst. The postoperative clinical course was uneventful with radiologically proven reduction of the size of the ventricular system and the cyst. Conclusion: Cystoventriculoperitoneal shunt placement after transtentorial endoscopic ventriculostomy is a surgical alternative in very young children with DWM and associated aqueductal obstruction.

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“…This is necessary because the authors use rigid lens scopes. The low frontal approach through the foramen of Monro to the posterior third ventricle region could be more safely achieved with direct visualization with a separately passed, simultaneously imaging coronal endoscope at the foramen of Monro as we have shown earlier [9]. Although the approach below the hairline requires only a small incision and burr hole, it certainly demonstrates cosmetic impact in the visualized face of the patient.…”

Section: Tamas Doczi Pecs Hungarymentioning

confidence: 85%

“…Furthermore, the technique has greatly evolved from simply treating the associated hydrocephalus [3,4,6,9,12,19,20,33,42,47,57,59, 65] to sampling tumor tissue, to tumor resection. The use of a rigid instrument offers more advantages such as superior optical and light quality thus giving the possibility to obtain larger quantities of pathological tissue in biopsies or even to perform various The intrinsic advantage of this technique is its ability to better identify and visualize neurovascular structures within the posterior third ventricle and pineal recess providing better control, better manipulation, and by consequence preservation of neural structures.…”

Section: Discussionmentioning

confidence: 99%

Neuroendoscopic management of posterior third ventricle and pineal region tumors: technique, limitation, and possible complication avoidance

Chibbaro

Rocco²,

Makiese

et al. 2012

Neurosurg Rev

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The endoscopic approach has gained an increased popularity in recent years for the biopsy and, in selected cases, the removal of tumors of the posterior third ventricle and pineal region. The authors report their experience on a series of 20 patients discussing also the technical limitations and complication avoidance. This is a prospective study of 20 patients with posterior third ventricle and pineal region tumors surgically managed by endoscopic biopsy and/or excision and simultaneous third ventriculostomy. The removal of the lesion could be achieved in 12 cases whereas in 8, only a biopsy could be performed. A histological diagnosis could be obtained in all cases. No delayed third ventricular stoma failures were recorded in any patient at the latest follow-up (mean follow-up, 39 months). Severe postoperative complications were recorded in 2 out of 12 cases of tumor removal attempt and in zero out of eight cases of biopsy. A delayed (3 weeks) postoperative mortality occurred in a patient harboring a GBM that developed an intratumoral hematoma 48 h postoperatively, one patient was in a vegetative state. Transient postoperative complications included: nausea and vomiting (five cases) and diplopia (two cases). One patient developed a bilateral ophthalmoplegia that recovered within 6 months due to residual tumor hemorrhage. Higher rate of complications was found in the case of vascularized and/or larger lesions. Endoscopic management of posterior third ventricle lesions may represent an effective option. However, though biopsies remain often a safe procedure, tumor excision should be limited to highly selected cases (cystic, poorly vascularized, and/or smaller than 2.5-cm lesions).

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Biportal Endoscopic Management of Third Ventricle Tumors in Patients with Occlusive Hydrocephalus: Technical Note

Cited by 49 publications

References 15 publications

The role of neuroendoscopy in the management of brain tumours

The role of neuroendoscopy in the management of brain tumours

Endoscopic Transtentorial Ventriculocystostomy and Cystoventriculoperitoneal Shunt in a Neonate with Dandy-Walker Malformation and Associated Aqueductal Obstruction

Neuroendoscopic management of posterior third ventricle and pineal region tumors: technique, limitation, and possible complication avoidance

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