Laser-assisted endoscopic third ventriculostomy for obstructive hydrocephalus: Technique and results in a series of 40 consecutive cases
✍ Scribed by Bertrand C. Devaux; Luc-Marie Joly; Philippe Page; François Nataf; Baris Turak; Frederic Beuvon; Denis Trystram; François-Xavier Roux
- Publisher
- John Wiley and Sons
- Year
- 2004
- Tongue
- English
- Weight
- 331 KB
- Volume
- 34
- Category
- Article
- ISSN
- 0196-8092
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✦ Synopsis
Abstract
Background and Objectives
To report a case series of endoscopic third ventriculostomy (ETV) using laser in 40 consecutive patients with obstructive hydrocephalus.
Study Design/Materials and Methods
Under stereotactic and endoscopic guidance, multiple perforations in the ventricular floor using a 1.32 μm neodymium–yttrium/aluminum/garnet (Nd–YAG) or a 0.805 μm diode laser unit and removal of intervening coagulated tissue ensued with a 4–6 mm opening between third ventricle and basilar cisterns.
Results
The procedure could be completed in all cases. A transient complication occurred in five cases. In 39 patients (mean follow‐up 28 months), 31 (79%) had a favorable outcome. Failure occurred in six patients, requiring permanent shunting leading to complete recovery, and two patients remained in a poor clinical status despite ETV.
Conclusions
Laser‐assisted ETV is a safe and efficient procedure for the treatment of obstructive hydrocephalus. Laser is advantageous in cases of distorted anatomy and may reduce technical failures. Lasers Surg. Med. 34:368–378, 2004. © 2004 Wiley‐Liss, Inc.