Artikel
Complications of endoscopic aqueductoplasty and stenting
Komplikationen der endoskopischen Aquäduktoplastie
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Autoren
Veröffentlicht: | 4. Mai 2005 |
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Gliederung
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Objective
Endoscopic aqueductoplasty has been established as one option for the treatment of aqueductal stenosis and isolated 4th ventricle. We previously reported our surgical technique and results. We now summarize our experience in regard of complications and lessons learned.
Methods
We retrospectively analyzed treatment and outcome of 24 patients who underwent endoscopic aqueductoplasty without or with stent. Surgeries were performed between July 1996 and December 2003. Mean age at time of surgery was 8 years and 8 months (4 months – 36 years). Mean follow-up is 24 months (12 – 84 months).
Results
We had the following complications: 1 infection that required removal of the stent and subsequent re-stenting, 2 transient and 1 permanent oculomotor paresis, 1 asymptomatic posterior fossa hygroma, 2 patients with stent migration (complication rate 23%; 7 / 30 patients). Reclosure rate following aqueductoplasty without stenting was determined by the etiology of the aqueductal stenosis.
Conclusions
Endoscopic aqueductoplasty without or with stenting has a learning curve, as any other surgical procedure. Complications can be avoided or reduced by learning from previous experiences. Patients with isolated 4th ventricle are the best candidates for the procedure. Stent migration can be avoided by placing a stent that communicates lateral, 3rd and 4th ventricle and is secured by a subcutaneous burr hole reservoir. Reclosure rate following aqueductoplasty can be reduced by stent placement.