Endoscopic aqueductoplasty and stenting in the treatment of isolated fourth ventricle in children: 20-year institutional experience

Autor: Pietro Spennato, Giuliana Di Martino, Giuseppe Cinalli, Giuseppe Mirone, Claudio Ruggiero, Ferdinando Aliberti, Luz Monserrat Almaguer Ascencio, Alessia Imperato
Rok vydání: 2021
Předmět:
Zdroj: Child's Nervous System. 37:1587-1596
ISSN: 1433-0350
0256-7040
DOI: 10.1007/s00381-020-05024-4
Popis: Endoscopic aqueductoplasty with aqueductal stenting is an effective surgical procedure for the treatment of isolated fourth ventricle (IFV). Due to the rarity of the underlying pathology, it can be considered a rare procedure that can be performed with different surgical techniques and approaches. To assess long-term functioning of permanent aqueductal stents implanted in children affected by hydrocephalus and IFV and to describe some variations of the same procedure. We reviewed retrospectively all the patients presenting at our institution in the years 1999–2019 for symptoms of isolated fourth ventricle who underwent a surgical procedure of endoscopic aqueductoplasty and/or aqueductal stent. Surgical reports, radiological images, and surgical videos were retrospectively analyzed. Thirty-three patients with symptomatic isolated fourth ventricle (IFV) underwent fifty (50) neuroendoscopic procedures in the period observed. The median age of the patients at the time of first surgery was 7 months, with 22 premature babies. In twenty-nine patients (87.8%), a precoronal approach was performed, while four patients received a suboccipital burr hole. Ten patients were never reoperated since. Twenty-three patients underwent further surgeries: a new aqueductoplasty with aqueductal stent was performed in 13 cases. The remaining 10 patients required a combination of other procedures for management of hydrocephalus. Long-term follow-up showed a permanent stent functioning rate of 87% at 2 years and 73% at 4 years, remaining stable afterwards at very long term (20 years). Endoscopic aqueductoplasty and stenting is a reliable procedure in the long-term management of isolated fourth ventricle.
Databáze: OpenAIRE
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