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Neuroendoscopy in the management of pineal tumors

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Abstract

Introduction

Endoscopy has been applied for the management of pineal tumors and the associated obstructive hydrocephalus. The techniques include endoscopic third ventriculostomy (ETV), endoscopic biopsy, and endoscopic-assisted open surgery of tumor in selected cases. The purpose of this study is to report our experience and techniques of endoscopic surgeries for pineal tumors in children.

Methods

This is a retrospective review of 36 ETVs, 25 endoscopic transventricular biopsies (ETB), 2 endoscopic transnasal transsphenoid biopsies, and 5 endoscopic-assisted open resections of pineal tumors.

Results

One patient died of delay tumor hemorrhage after ETV and ETB were excluded. With a mean follow-up period of 5.4 years, ETV failure occurred in 7 of 35 patients with long-term success rate of 80.0%. Histological diagnosis was established in 21 of 25 (84.0%) patients through ETBs. Tissue diagnosis was obtained in two selected patients with bifocal germ cell tumors by endsocopic transnasal transsphenoid approach to the intrasellar lesion. Direct radical resections were achieved in four of five selected patients of pineal tumors with hydrocephalus by endoscopic-assisted open surgery.

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Acknowledgment

This clinical research work is supported by grant # DOH99-TD-C-111-007 and the Pediatric Neuroscience Research Plan from Taipei Veterans General Hospital, Taipei, Taiwan.

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Authors and Affiliations

  1. Division of Pediatric Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, VACRS, No. 201, Sec 2, Shi-Pai Rd., Taipei, Taiwan, Republic of China, , 11217

    Tai-Tong Wong, Hsin-Hung Chen & Muh-Lii Liang

  2. National Yang Ming Medical University School of Medicine, Taipei, Taiwan, Republic of China

    Tai-Tong Wong

  3. Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China

    Yu-Shu Yen

  4. Department of Radiology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China

    Feng-Chi Chang

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  1. Tai-Tong Wong
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  2. Hsin-Hung Chen
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  3. Muh-Lii Liang
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  4. Yu-Shu Yen
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  5. Feng-Chi Chang
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Correspondence to Tai-Tong Wong.

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Wong, TT., Chen, HH., Liang, ML. et al. Neuroendoscopy in the management of pineal tumors. Childs Nerv Syst 27, 949–959 (2011). https://doi.org/10.1007/s00381-010-1325-5

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  • DOI: https://doi.org/10.1007/s00381-010-1325-5

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