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Farag AA, Asiri FA, Khoudir MA, Ismaeel M, Hamouda W, Alaghory IM, Moshref RH. Endoscopic third ventriculostomy complications: avoidance and management in a stepwise manner. Egypt J Neurosurg 2022. [DOI: 10.1186/s41984-022-00166-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Various complications of endoscopic third ventriculostomy (ETV) have been described. One has to recognize these complications and learn how to avoid them.
Methods
We performed a literature review regarding the reported complications of ETV procedures discussed in a correlated manner with the surgical steps. Furthermore, we reviewed the technical notes described by experienced neuroendoscopists, including surgical indications, choice of the endoscopic entry point and trajectory, anatomic orientation, proper bleeding control and tight closure, to prevent and deal with such complications.
Results and conclusion
A lesson learned that comprehensive knowledge of ventricular anatomy with proper orientation by studying the preoperative images is mandatory and one should be aware of all complication types and rates.
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Buyuktepe M, Alpergin BC, Abbasoglu B, Orhan O, Ozgural O. Acute hydrocephalus caused by a gelatin-sponge material: a case report. Childs Nerv Syst 2022; 38:847-9. [PMID: 34313829 DOI: 10.1007/s00381-021-05292-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 07/10/2021] [Indexed: 10/20/2022]
Abstract
Third ventricle lesions, especially those located proximally to the foramen of Monro, generally present with obstructive hydrocephalus symptoms. In this report, we present a case with acute obstructive hydrocephalus secondary to a gel-foam material. The patient has previously underwent an endoscopic cystectomy. At postoperative third month, she admitted to our hospital with the complain of headache. Neuroradiological imaging revealed triventricular hydrocephalus. A second endoscopic operation was performed, and a piece of gelatin-sponge material was detected at the level of cerebral aqueduct, which obstructed the flow of cerebrospinal fluid (CSF). The CSF flow was immediately restored after removing this material, and an additional third ventriculostomy was performed.
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Coulter IC, Dewan MC, Tailor J, Ibrahim GM, Kulkarni AV. Endoscopic third ventriculostomy and choroid plexus cauterization (ETV/CPC) for hydrocephalus of infancy: a technical review. Childs Nerv Syst 2021; 37:3509-3519. [PMID: 33991213 DOI: 10.1007/s00381-021-05209-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 05/06/2021] [Indexed: 10/21/2022]
Abstract
In the twenty-first century, choroid plexus cauterization (CPC) in combination with endoscopic third ventriculostomy (ETV) has emerged as an effective treatment for some infants with hydrocephalus, leading to the favourable condition of 'shunt independence'. Herein we provide a narrative technical review considering the indications, procedural aspects, morbidity and its avoidance, postoperative care and follow-up. The CP has been the target of hydrocephalus treatment for more than a century. Early eminent neurosurgeons including Dandy, Putnam and Scarff performed CPC achieving generally poor results, and so the procedure fell out of favour. In recent years, the addition of CPC to ETV was one of the reasons greater ETV success rates were observed in Africa, compared to developed nations, and its popularity worldwide has since increased. Initial results indicate that when ETV/CPC is performed successfully, shunt independence is more likely than when ETV is undertaken alone. CPC is commonly performed using a flexible endoscope via septostomy and aims to maximally cauterize the CP. Success is more likely in infants aged >1 month, those with hydrocephalus secondary to myelomeningocele and aqueductal obstruction and those with >90% cauterized CP. Failure is more likely in those with post-haemorrhagic hydrocephalus of prematurity (PHHP), particularly those <1 month of corrected age and those with prepontine scarring. High-quality evidence comparing the efficacy of ETV/CPC with shunting is emerging, with data from ongoing and future trials offering additional promise to enhance our understanding of the true utility of ETV/CPC.
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Affiliation(s)
- Ian C Coulter
- Division of Neurosurgery, Hospital for Sick Children (SickKids), Rooms 1504 & 1503, Hill Wing, 555 University Avenue, Toronto, Ontario, M5G 1X8, Canada.
| | - Michael C Dewan
- Division of Neurosurgery, Hospital for Sick Children (SickKids), Rooms 1504 & 1503, Hill Wing, 555 University Avenue, Toronto, Ontario, M5G 1X8, Canada
| | - Jignesh Tailor
- Division of Neurosurgery, Hospital for Sick Children (SickKids), Rooms 1504 & 1503, Hill Wing, 555 University Avenue, Toronto, Ontario, M5G 1X8, Canada
| | - George M Ibrahim
- Division of Neurosurgery, Hospital for Sick Children (SickKids), Rooms 1504 & 1503, Hill Wing, 555 University Avenue, Toronto, Ontario, M5G 1X8, Canada
| | - Abhaya V Kulkarni
- Division of Neurosurgery, Hospital for Sick Children (SickKids), Rooms 1504 & 1503, Hill Wing, 555 University Avenue, Toronto, Ontario, M5G 1X8, Canada
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Cearns MD, O'Kane R. Reply to the letter to the editor from Lo WB, Afshari FT, Rodrigues D and Kulkarni AV regarding the article "Opening and closure of intraventricular neuroendoscopic procedures in infants under 1 year of age: institutional technique, case series and review of the literature". Childs Nerv Syst 2021; 37:1411-2. [PMID: 33591369 DOI: 10.1007/s00381-020-05025-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 12/18/2020] [Indexed: 10/22/2022]
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Lo WB, Afshari FT, Rodrigues D, Kulkarni AV. Letter to the Editor Re: Cearns MD, Kommer M, Amato-Watkins A, Campbell E, Beez T, O'Kane R (2020) Opening and closure of intraventricular neuroendoscopic procedures in infants under 1 year of age: institutional technique, case series and review of the literature. Childs Nerv Syst 2021; 37:1407-8. [PMID: 33090250 DOI: 10.1007/s00381-020-04936-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 10/19/2020] [Indexed: 10/23/2022]
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