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Third ventricular shape: a predictor of endoscopic third ventriculostomy success in pediatric patients

Clinical article

Mansoor Foroughi, Andrew Wong, Paul Steinbok, Ash Singhal, Michael A. Sargent, and D. Douglas Cochrane

T he criteria for considering third ventriculostomy as the definitive treatment for hydrocephalus were originally based on Dandy's concepts 1 , 2 of communicating and obstructive hydrocephalus. Even with current imaging modalities, it is not always possible to determine, preoperatively, the location of CSF pathway obstruction. As a result, some patients may be denied third ventriculostomy in favor of a ventricular shunt if demonstrated intraventricular obstruction is an absolute indication for this procedure. As the clinical experience with ETV has evolved

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Palliative endoscopic third ventriculostomy for pediatric primary brain tumors: a single-institution case series

Robert C. Rennert, Michael G. Brandel, Shanmukha Srinivas, Divya Prajapati, Omar M. Al Jammal, Nolan J. Brown, Luis D Diaz-Aguilar, Jennifer Elster, David D. Gonda, John R. Crawford, and Michael L. Levy

tumors: the role of endoscopic third ventriculostomy . J Neurosurg . 2001 ; 95 ( 5 ): 791 – 797 . 11702869 10.3171/jns.2001.95.5.0791 9 Hailong F , Guangfu H , Haibin T , Endoscopic third ventriculostomy in the management of communicating hydrocephalus: a preliminary study . J Neurosurg . 2008 ; 109 ( 5 ): 923 – 930 . 10.3171/JNS/2008/109/11/0923 18976086 10 Rangel-Castilla L , Barber S , Zhang YJ . The role of endoscopic third ventriculostomy in the treatment of communicating hydrocephalus . World Neurosurg . 2012 ; 77 ( 3-4 ): 555 – 560

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Endoscopic third ventriculostomy in the management of obstructive hydrocephalus: an outcome analysis

Hailong Feng, Guangfu Huang, Xiaoling Liao, Kai Fu, Haibin Tan, Hong Pu, Yong Cheng, Weidong Liu, and Dongdong Zhao

appearance after ETV, we defined it as clinical presentation in the first 2 weeks after ETV and classified it with the same criteria as those used for the ETV outcome evaluation. Repeated CT or MR images (the initial study was completed within 2 weeks after ETV) were obtained in each patient to evaluate the results of surgery and during the follow-up period, including 29 patients in whom cine phase—contrast MR images were obtained to verify the patency of the stoma. Endoscopic Maneuver Endoscopic third ventriculostomy was performed using the freehand method in all

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Endoscopic third ventriculostomy: an outcome analysis of primary cases and procedures performed after ventriculoperitoneal shunt malfunction

Donncha F. O'Brien, Mohsen Javadpour, David R. Collins, Pietro Spennato, and Conor L. Mallucci

puncture after the ETV for cases in which recurrent symptoms of raised ICP developed; instead, we proceeded to shunt insertion. Follow-Up Evaluation All patients underwent MR imaging 1 day postoperatively with flow studies to establish the patency of the third ventriculostomy. If asymptomatic, patients were discharged on average on Day 3 and were examined in the outpatient clinic 2 weeks later, subsequently at 2-month intervals, and then yearly as appropriate clinically. All patients and their primary physicians were asked to contact the neurosurgery office if

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Endoscopic stent placement for treatment of secondary bilateral occlusion of the Monro foramina following endoscopic third ventriculostomy in a patient with aqueductal stenosis

Case report

Hiroshi Mori, Toshiro Koike, Tsuyoshi Fujimoto, Kenichi Nishiyama, Junichi Yoshimura, and Ryuichi Tanaka

✓ Nontumoral bilateral occlusion of the Monro foramina is a rare clinical condition. Treatment includes shunt placement, endoscopic procedures, or both. The authors describe the case of a 22-year-old woman who had previously undergone placement of a ventriculoperitoneal shunt via a right frontal approach for management of triventricular dilation due to aqueductal stenosis. Six years postoperatively she presented with right-sided slit-ventricle syndrome and stenosis of the right Monro foramen, which was treated with an endoscopic third ventriculostomy and fenestration of the septum pellucidum. Two years later she presented with bilateral lateral ventricular dilation. Inspection of the right lateral ventricle with a fiberscope revealed occlusion of the septum pellucidum fenestration; on observation, the right Monro foramen was covered by thick, tough granulation tissue and the left was occluded by thin membranous tissue. Repeated fenestration of the septum pellucidum and left Monro foraminoplasty were therefore performed by perforating this thin tissue. A stent was then introduced into the third ventricle via the right lateral ventricle, the fenestration in the septum pellucidum, and the left Monro foramen.

The authors note that fiberscopes are in general more maneuverable than rigid endoscopes and conclude that they are particularly useful for the treatment of this type of hydrocephalus.

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Reopening of an obstructed third ventriculostomy: long-term success and factors affecting outcome in 215 infants

Paul J. Marano, Scellig S. D. Stone, John Mugamba, Peter Ssenyonga, Ezra B. Warf, and Benjamin C. Warf

I nfant hydrocephalus is a common cause of death and disability in sub-Saharan Africa, and unlike in more developed countries, the predominant cause is neonatal infection. 11–13 Shunt dependence is dangerous where timely access to emergency shunt revision surgery is typically not possible. Endoscopic third ventriculostomy (ETV) can be an alternative treatment, but is not successful in the majority of infants younger than 1 year of age. Studies over the past decade at CURE Children's Hospital of Uganda have demonstrated the efficacy of combining ETV and

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Endoscopic third ventriculostomy with choroid plexus cauterization outcome: distinguishing success from failure

Michael C. Dewan, Jaims Lim, Clinton D. Morgan, Stephen R. Gannon, Chevis N. Shannon, John C. Wellons III, and Robert P. Naftel

E ndoscopic third ventriculostomy with choroid plexus cauterization (ETV/CPC) for the treatment of infantile hydrocephalus is being performed as an alternative to shunting. 7 , 11 , 12 , 16 Multiple validated success scales exist as simple tools to calculate the expected success rate of endoscopically treated hydrocephalus based on preoperative variables. 6 , 15 All of these predictive models depend on the manner in which the diagnosis of failure is established. The decision making in diagnosing ETV/CPC success or failure remains subjective, ambiguous

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Quality of life in children with hydrocephalus treated with endoscopic third ventriculostomy

Ángela Ros-Sanjuán, Sara Iglesias-Moroño, Bienvenido Ros-López, Francisca Rius-Díaz, Andrea Delgado-Babiano, and Miguel Ángel Arráez-Sánchez

hydrocephalus at our hospital, we designed a parallel study in patients treated successfully with endoscopic third ventriculostomy (ETV). The aims of this study were to determine the quality of life (using the HOQ-Sv) of a cohort of children with hydrocephalus treated by ETV, and analyze the clinical and radiological features associated with a better or worse functional status. Methods Study Cohort We undertook this cross-sectional study between September 2018 and December 2019. The parents of 40 school-aged children (5–18 years old) treated with ETV at the

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Subarachnoid dissemination of intraventricular tumors following simultaneous endoscopic biopsy and third ventriculostomy

Clinical article

Neal Luther, William R. Stetler Jr., Ira J. Dunkel, Paul J. Christos, John C. Wellons III, and Mark M. Souweidane

, 31 , 35 , 40 , 42 Colloid cysts can be safely and effectively removed via the endoscope, and recent publications have also suggested that selected solid tumors may be excellent candidates for resection using this minimally invasive approach. 1 , 5 , 16 , 20 , 37 , 40 , 41 A significant percentage of patients with posterior third ventricular or pineal region tumors present with noncommunicating hydrocephalus. For these patients, combined ETV to relieve hydrocephalus and tumor biopsy to establish a diagnosis is warranted. Endoscopic third ventriculostomy has

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Design and evaluation of a new synthetic brain simulator for endoscopic third ventriculostomy

Gerben E. Breimer, Vivek Bodani, Thomas Looi, and James M. Drake

subspecialization, demand for more time- and cost-effective practices, and increased demand for patient safety. 11 , 19–21 Because of these challenges, there has been an increased interest in using models and simulators for neurosurgical education. 21 , 22 , 26 An ideal procedure for simulation training is endoscopic third ventriculostomy (ETV). Although ETV is an effective and widely accepted treatment for obstructive hydrocephalus, 9 , 23 , 29 it is technically challenging and carries the risk for serious errors, such as getting lost or disoriented and being unfamiliar with