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Neuroendoscopic foraminal plasty of foramen of Monro

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Abstract

Objectives

The aims of this study were to describe and analyze the technique of neuroendoscopic foraminal plasty of foramen of Monro (NEFPFMO) in the treatment of isolated unilateral hydrocephalus (IUH) due to membranous occlusion, to evaluate its efficacy and safety, and to define the benefits of neuronavigational guidance of the procedure.

Materials and methods

Two symptomatic neonates with IUH, as a result of congenital atresia of foramen of Monro, underwent NEFPFMO plus neuroendoscopic septostomy in the first case and neuronavigational guidance in the second one.

Clinical results were excellent in both neonates. The postoperative ventricular size decreased and the progressive IUH changed to the state of arrested hydrocephalus. The neuronavigation was precise.

Conclusion

NEFPFMO should be the primary treatment option in patients with IUH due to membranous occlusion of foramen of Monro. It reestablishes natural anatomical communication and provides real physiological cerebrospinal fluid flow. Neuronavigation is a useful adjunct of NEFPFMO.

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Acknowledgment

Dr. Yavor Enchev, Ph.D. is a neurosurgeon in the Department of Neurosurgery, Medical University-Sofia, Bulgaria. During the period of elaboration of the manuscript, he was a holder of “Prof. Oi Neuroendoscopy Fellowship”, supported by “Karl Storz-Japan” Scholarship.

Disclosure

The first author was involved in the design of the aforementioned endoscope. He was not involved in the economic exploitation of the instrument.

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Authors and Affiliations

  1. Division of Pediatric Neurosurgery, The Jikei University Hospital, Women’s and Children’s Medical Center, Tokyo, Japan

    Shizuo Oi & Yavor Enchev

  2. Department of Neurosurgery, Medical University-Sofia, University Hospital “Sv. Ivan Rilsky”, 15, Boulv. “Acad. Ivan Geshov”, 1431, Sofia, Bulgaria

    Yavor Enchev

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  1. Shizuo Oi
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  2. Yavor Enchev
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Correspondence to Yavor Enchev.

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Oi, S., Enchev, Y. Neuroendoscopic foraminal plasty of foramen of Monro. Childs Nerv Syst 24, 933–942 (2008). https://doi.org/10.1007/s00381-008-0627-3

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  • DOI: https://doi.org/10.1007/s00381-008-0627-3

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