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Minim Invasive Neurosurg 2001; 44(1): 25-30
DOI: 10.1055/s-2001-13587
ORIGINAL PAPER
Georg Thieme Verlag Stuttgart · New York

Endoscopic Treatment of Hydrocephalus in Children:A Controlled Study using Newly Developed Yamadori-Type Ventriculoscopes

S. Kamikawa1, 2 , A. Inui3 , N. Kobayashi1 , K. Kuwamura2 , M. Kasuga3 , T. Yamadori4 , N. Tamaki2
  • 1Department of Neurosurgery, Kobe University School of Medicine, Kobe, Japan
  • 2Department of Neurosurgery, Kobe Children's Hospital, Kobe, Japan
  • 3Second Department of Internal Medicine, Kobe University School of Medicine, Kobe, Japan
  • 4Health Care Division, Himeji Dokkyo University, Himeji, Japan
Further Information

Publication History

Publication Date:
31 December 2001 (online)

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Although cerebrospinal fluid (CSF) shunting is the most common neurosurgical treatment for hydrocephalus, the long-term results have still been unsatisfactory because of a wide variety of shunt complications. We have recently developed flexible ventriculoscopes (Yamadori-type) which have excellent image quality, maneuverability, and capabilities for endoscopic operation. Here we report the efficacy of the new treatment in 88 children with hydrocephalus who initially underwent either ventriculoscopic operation or shunting surgery. The primary outcome measures were the rate of shunt independency and/or shunt complications with a follow-up of 2 years in each group. We performed endoscopic third ventriculostomy in cases of aqueductal stenosis, cyst fenestration, and choroid plexus coagulation in limited cases of communicating hydrocephalus. Overall, thirty-three (75 %) of the 44 children initially treated endoscopically did not require ventriculoperitoneal (VP) shunts. The endoscopic procedures were repeated in the remaining 11 children (25 %) mostly less than 1-year-old who ultimately required endoscope-guided VP shunting. Even in such patients, there was virtually no need for shunt revisions and no major complications such as slit-like ventricle, meningitis, and intraventricular hemorrhage. These results were statistically highly significant (p < 0.0001) compared to a control group of 44 patients treated initially by VP shunting. Our data demonstrate that therapeutic ventriculoscopy is safe and clinically effective as the first-line treatment of hydrocephalus in children.

Key words:

Pediatric hydrocephalus - Therapeutic ventriculoscope - Shunt independence - Shunt complications - Third ventriculostomy

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Corresponding Author

A Inui,M. D., Ph. D 

Second Department of Internal Medicine
Kobe University School of Medicine

7-5-2, Kusunoki-cho, Chuo-ku Kobe 650-0017
Japan

Phone: Phone: +81-78-382-5862

Fax: Fax: +81-78-382-2080

Email: E-mail: inui@med.kobe-u.ac.jp

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