Background: Pineal region tumors often present with hydrocephalus. Endoscopic third ventriculostomy
(ETV) and simultaneous tumor biopsy remain a minimally invasive procedure offering
both diagnostic and therapeutic advantages in the management of these tumors. However,
different operative techniques have been described in the literature. Aim: The aim is to study the ETV success rate, diagnostic rate of simultaneous tumor biopsy,
complications, and follow-up of patients of pineal region tumors managed with ETV
and simultaneous tumor biopsy using the single burr hole technique. Methods: The study was performed by retrospectively reviewing the records of patients of pineal
region tumors managed by simultaneous ETV and tumor biopsy using a “single burr hole”
technique from January 2012 to December 2019. Results: Thirty-four patients (22 males and 12 females) with a mean age of 28.7 years were
analyzed. ETV was successful in relieving hydrocephalus in 29 (87.8%) patients. Three
patients needed a ventriculoperitoneal shunt, and one required Ommaya reservoir placement
for persistent hydrocephalus. Histological diagnosis was successfully established
in 26 (78.8%) patients. There were two procedure-related mortalities. Two patients
underwent craniotomy and tumor excision subsequently. Radiotherapy was given to 11
patients, and 9 patients were managed by observation alone. The mean follow-up of
our study was 15.8 months. Conclusions: Simultaneous ETV and tumor biopsy using a single burr hole technique is a safe, minimally
invasive procedure for the management of pineal region tumors.
Key-words:
Endoscope - pineal region tumors - posterior third ventricle tumors - single burr
hole - third ventriculostomy
