The clinical observation of endoscopic third ventriculostomy the fistula treatment of obstructive hydrocephalus
|Keywords||Neuroendoscopy Obstructive hydrocephalus Third ventriculostomy Shunt MIDBRAINPERIAQUEDUCTAL dilatation|
Objective: To investigate the nervous endoscopic third ventricle fistula (endoscopic third ventriculostomy ETV) surgical method for the treatment of obstructive hydrocephalus patients, analyzed the clinical data, according to the follow-up results of the ETV surgery objective clinical assessment . Clarify the the best operative time about ETV, indications for surgery and its superiority for bypass surgery. Method: During 2000-2004 the ETV surgical treatment for 13 cases due to different causes of obstructive hydrocephalus patients. Adult patients and pediatric patients plus a the midbrain aqueduct balloon dilatation. Results: The follow-up of 1-48 months, 11 patients completed the follow-up results are shown to the surgery, 9 cases, five cases which obviously effective. The 8 patients microscope ventricular dilatation ventricle anatomical structure is basically normal. 8 cases of postoperative recovery process smooth, preoperative symptoms mostly disappeared. Two cases after the bottom of the third ventricle gastrostomy, depending on the circumstances, while doing the aqueduct dilatation. Patients in addition to suffering from obstructive hydrocephalus, concomitant Sacral bifida, sacral the dermal sinus lumbar spinal canal placeholder, the children with severe meningitis. Basically control the infection after successful completion of a spinal tumor resection ETV. However, no significant improvement in the symptoms of hydrocephalus. Cases of pediatric patients found that the merger intraventricular hemorrhage persistent, Department of premature children due to intraventricular hemorrhage. The microscope will be visible clot sucked the smooth progress of the fistula, early postoperative recovery, month and a half after the children head began to significantly increase CT dynamic observation found the ventricle continued expansion, three months after ventriculo - peritoneal shunt for treatment. Found another one cases of patients with hydrocephalus caused by pineal region tumor surgery with the bottom of the third ventricle subsidence, a short distance between the bottom of the third ventricle and the basilar artery, in order to avoid forced ostomy lead to fatal basilar artery injury give up the gastrostomy row γ-knife radiotherapy after 6 months switch to ventriculo - peritoneal shunt for treatment. A case of 18-year-old male patient had to be terminated because of arterial bleeding in surgery colostomy surgery. No deaths in this group. Conclusion: For patients with obstructive hydrocephalus, ETV is a safe and effective surgical treatment. However, in order to improve surgical outcome, reduce postoperative complications, should choose a good surgical instruments, master the surgical method to select the appropriate patients.