Article
Advantages of endoscopical cystoventriculostomy and biopsy with the aid of neuronavigation in patients with intraventricular processes in comparison to stereotactic procedure
Vorteile der endoskopischen Zystoventrikuolostomie und Biopsie unter Zuhilfenahme der Neuronavigation bei Patienten mit intraventrikulärer Raumforderung im Vergleich zur Stereotaxie
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Published: | April 23, 2004 |
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Outline
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Objective
33 Patients (18 female, 15 male, age 13-82 years) with occlusive hydrocephalus due to intraventricular processes were treated in endoscopic technique.
Methods
In these cases the endoscopical cystoventriculostomy and biopsy has been selected as operation method. The neuronavigation has been used for the optimisation of the operation approach. For diseases in the area of the 3rd ventricle there are threee possiblilities: microsurgery, stereotaxy, and endoscopic method. In patients with unclear diagnosis and other clinically limiting conditions the endoscopic guided method as a minimally invasive method should be selected.
Results
With the endoscopical method the intraventricular processes could be visualized. A necessary haemostais could be performed under direct vision in case of eventually occuring bleeding. In addition to the biopsy extraction the occlusive hydrocephalus could be also treated with this method in approximately 70% of the patients. There was no complications or bleedings postoperatively. There was in 70-90% of the cases a reliability of histopathological diagnosis. In comparison with the stereotactic method it has the same grade of accuracy. (Mennel HD et al, 1994, Zentralblatt für Neurochirurgie). There has been no morbidity or mortalitity postoperatively in consequence of this treatment.
Conclusions
This method of endoscopical biopsy and cystoventriculostomy has in comparison with the stereotactic method the same grade of accuracy and reliability. It has also more advantages, such as: Visualisation of the operation area and avoiding of complications postoperatively. The hydrocephalus can also be treated concurrently in the most cases.