Endoscopic Approach to Noncommunicating Fluid Spaces in the Shunted Patient

Yamini, Bakhtiar; Goumnerova, L.; Frim, David M.

doi:10.1159/000028869

Cited by 7 publications

(4 citation statements)

References 10 publications

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“…Both approaches result in increased morbidity for a variety of reasons, including the vascularity of the pineal region. 22 Furthermore, recovery and operative time are longer in most cases accomplished via a microsurgical approach.…”

Section: Discussionmentioning

confidence: 99%

The Role of Neuroendoscopy in the Treatment of Pineal Region Tumors

Romero¹,

Bertolini²,

Sestari³

et al. 2018

jbnc

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Object. The authors report their experience in six patients presenting with pineal tumors and associated hydrocephalus who underwent an endoscopic biopsy procedure and third ventriculostomy (ETV) in a single setting. The purpose of this report is to discuss the role of neuroendoscopic procedures in the management of pineal region tumors. Methods. A retrospective review of patients undergoing simultaneous ETV and tumor biopsy was ndertaken. Neuroendoscopic surgery was first applied for tumor debulking with tissue diagnosis and gross morphological analysis of the tumor and the intraventricular structures, followed by third ventriculostomy. Subsequent procedures were determined on the basis of verified individual tumors. Results. Over a 2-year interval, 6 patients underwent simultaneous ETV and tumor management. These patients ranged from 6 to 54 years of age (mean 24.3 years). All cases were completed without complications or the need for an additional CSF diversionary procedure within 6 months. The diagnostic yield of the biopsy was 100%. Favorable therapeutic outcomes were obtained in all cases of germinoma and pineoblastoma, with follow-up periods ranging from 6 to 24 months. Conclusion. The majority of our patients with dilated ventricles were treated satisfactorily with effective neuroendoscopic procedures as the initial procedure, avoiding unnecessary craniotomy and promising excellent therapeutic outcomes.

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Section: Discussionmentioning

confidence: 99%

The Role of Neuroendoscopy in the Treatment of Pineal Region Tumors

Romero¹,

Bertolini²,

Sestari³

et al. 2018

jbnc

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“…2,15,21,28 With the broadening use of neuroendoscopy, it became used in the setting of multiloculated hydrocephalus. 9,10,19,24,25,32,39 The advantage of using an endoscope for visualization in contrast to open cyst fenestration is obvious because it minimizes the size of skull opening, brain retraction and trauma, and facilitates deep access mainly through preformed and existing cavities. One advantage in endoscopic shunt placement is that the surgeon has intraoperative control of the position of the inserted catheters, thereby potentially decreasing the risk of malpositioning.…”

Section: Discussionmentioning

confidence: 99%

Navigated endoscopic surgery for multiloculated hydrocephalus in children

Schulz¹,

Böhner

Knaus³

et al. 2010

PED

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Object Multiloculated hydrocephalus remains a challenging condition to treat in the pediatric hydrocephalic population. In a retrospective study, the authors reviewed their experience with navigated endoscopy to treat multiloculated hydrocephalus in children. Methods Between April 2004 and September 2008, navigated endoscopic procedures were performed in 16 children with multiloculated hydrocephalus (median age 8 months, mean age 16.1 ± 23.3 months). In all patients preoperative MR imaging was used for planning entry sites and trajectories of the endoscopic approach for cyst perforation and catheter positioning. Intraoperatively, a rigid endoscope was tracked by the navigation system. For all children the total number of operative procedures, navigated endoscopic procedures, implanted ventricular catheters, and drained compartments were recorded. In addition, postoperative complications and radiological follow-up data were analyzed. Results In 16 children, a total of 91 procedures were performed to treat multiloculated hydrocephalus, including 29 navigated endoscopic surgeries. Finally, 21 navigated procedures involved 1 ventricular catheter and 8 involved 2 catheters for CSF diversion via the shunt. The average number of drained compartments in a shunt was 3.6 ± 1.7 (range 2–9 compartments). In 9 patients (56%) a navigated endoscopic procedure constituted the last procedure within the follow-up period. One additional surgery was necessary in 3 patients (19%) after navigated endoscopy, and in 4 patients (25%) 2 further procedures were necessary after navigated endoscopy. Serial follow-up MR imaging demonstrated evidence of sufficient CSF diversion in all patients. Conclusions Navigated endoscopic surgery is a safe and effective treatment option for multiloculated hydrocephalus. The combination of the endoscopic approach and neuronavigation further refines preoperative planning and intraoperative orientation. The aim of treatment is to drain as many compartments as possible and as soon as possible, thereby establishing sufficient CSF drainage with few ventricular catheters in single shunt systems. Close clinical and radiological follow-up is mandatory because multiple revisions are likely.

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“…Since the introduction of minimally invasive techniques to neurosurgery, many advances have been made in both operative technique and surgical equipment. Minimally invasive surgical approaches have gained popularity in spinal neurosurgery [1] and pediatric neurosurgery [2] . Advances in endoscopes, and the wide application of endoscopy in sinus surgery, have led to the common use of this equipment in anterior skull base and transsphenoidal pituitary surgery [3] .…”

Section: Introductionmentioning

confidence: 99%

The Use of the Olympus EndoArm for Spinal and Skull-based Transsphenoidal Neurosurgery

Eskandari¹,

Amini²,

Ks³

et al. 2008

Minim Invasive Neurosurg

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Minimally invasive surgical techniques have evolved to reduce soft-tissue injury associated with open surgical techniques. The use of endoscopic visualization allows the exposure of deep structures and provides a mechanism to perform all the components of an open surgical procedure through small portals, thus satisfying a basic requirement of minimally invasive surgical procedures. Surgeons in the field of skull-base and spine surgery are now taking advantage of the benefits of such endoscopes. The pneumatically powered EndoArm endoscopic holder has been used extensively in both cranial and spinal neurosurgical cases at the University of Utah. These cases include minimally invasive cervical and lumbar decompression procedures, as well as more recently the resection of larger and more extensive pituitary tumors. In this paper, the multiple advantages of the Olympus EndoArm endoscopic holder are described in detail. As more surgeons gain experience with endoscopes in skull-base surgery, the hope is that operative times will be shorter and more extensive surgical resections will be possible with less patient morbidity.

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Endoscopic Approach to Noncommunicating Fluid Spaces in the Shunted Patient

Cited by 7 publications

References 10 publications

The Role of Neuroendoscopy in the Treatment of Pineal Region Tumors

The Role of Neuroendoscopy in the Treatment of Pineal Region Tumors

Navigated endoscopic surgery for multiloculated hydrocephalus in children

The Use of the Olympus EndoArm for Spinal and Skull-based Transsphenoidal Neurosurgery

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