Endoscopic aqueductoplasty in the treatment of aqueductal stenosis
- 236 Downloads
Endoscopic aqueductoplasty is an option of treatment of obstructive hydrocephalus caused by aqueductal stenosis. We report on our experience with this endoscopic technique.
Materials and methods
Eighteen patients with primary or secondary aqueductal stenosis underwent endoscopic aqueductoplasty (EA) with or without stenting between July 2004 and January 2007. EA, EA with a stent, EA with endoscopic third ventriculostomy (ETV), and EA with stenting in addition to ETV were performed in eight, five, three, and two patients, respectively. A repeat endoscopic procedure was done in one patient. EA with a stent was performed in case 1, 8 months after first endoscopic procedure. In four cases, aqueductoplasty with stent was performed through a suboccipital approach.
There were no deaths due to the neuroendoscopic procedures. All of the patients showed improvement or resolution of their preoperative symptoms, although in case 1 a new endoscopic procedure was performed: EA with a stent.
Cerebral aqueductoplasty is an effective and successful treatment for membranous and/or short-segment stenosis of the sylvian aqueduct. Endoscopic aqueductoplasty candidates must be selected very carefully but longer follow-up periods are necessary to evaluate long-term aqueductal patency after aqueductoplasty.
KeywordsEndoscopic aqueductoplasty Aqueduct stenosis Hydrocephalus Third ventriculostomy Stent Suboccipital approach
- 1.Rekate HL (2005) Endoscopic fourth ventricular aqueductoplasty. J Neurosurg (5 Suppl Pediatrics) 103:385–387Google Scholar
- 2.Sansone MJ, Iskandar BJ (2005) Endoscopic cerebral aqueductoplasty: a trans-fourth ventricle approach. J Neurosurg (5 Suppl Pediatrics) 103:388–392Google Scholar
- 3.Gorayeb RP, Cavalheiro S, Zymberg ST (2004) Endoscopic third ventriculostomy in children younger than 1 year of age. J Neurosurg (5 Suppl Pediatrics) 100:427–429Google Scholar
- 5.Drake J, Chumas P, Kestle J, Pierre-Kahn A, Vinchon M, Brown J, Pollack IF, Arai H (2006) Late rapid deterioration after endoscopic third ventriculostomy: additional cases and review of the literature. J Neurosurg (2 Suppl Pediatrics) 105:118–126Google Scholar
- 6.Jones R, Kwok BCT, Stening WA (1996) Endoscopic third ventriculostomy: how long does it last? Child’s Nerv Syst 12:364–365Google Scholar
- 14.Russell DS (1949) Observations on the pathology of hydrocephalus. Special report series no. 265. Medical Research Council, London, HM Stationery Office, pp 119–122Google Scholar
- 16.Cinalli G, Spennato P, Savarese L, Ruggiero C, Aliberti F, Cuomo L, Cianciulli E, Maggi G (2006) Endoscopic aqueductoplasty and placement of a stent in the cerebral aqueduct in the management of isolated fourth ventricle in children. J Neurosurg (1 Suppl Pediatrics) 104:21–27Google Scholar