Artikel
Endoscopy in children of less than 14 years: experience with 96 procedures
Endoskopie bei Kindern: Erfahrung mit 96 Eingriffen
Suche in Medline nach
Autoren
Veröffentlicht: | 4. Mai 2005 |
---|
Gliederung
Text
Applications of endoscopy in neurosurgery are frequent. However, pediatric surgery possesses peculiar characteristics and is associated with a different surgical success rate. Here, the authors report their series of 96 consecutive endoscopic procedures in children of less than 14 years. Between April 1993 and December 2004, 96 endoscopic procedures were performed in 91 children. Indications consisted of hydrocephalus in 52 cases, arachnoid or parenchymal cysts in 22 cases, and brain tumors in 16 cases. In 6 cases, only a ventriculoscopy was performed.
There were 57 endoscopic ventriculostomies, 14 aqueductoplasties including 5 stent implantations, 10 cystocisternostomies, 6 cystoventriculostomies, 6 ventriculocystocisternostomies and 10 septostomies performed. In the 16 tumor cases, endoscopic tumor resection was performed in 8 and a tumor biopsy in 5. The procedure had to be abandoned for recurrent hemorrhage in 3 tumors. There was no mortatlity. There was one case of transient trochlear nerve, oculomotor nerve palsy, and ventriculitis each. Five patients had to undergo endoscopic revision for stomy reclosure. Two patients presented with hypothalamic disturbances including weight gain after ventriculostomy. An follow-up, 62 out of 91 children improved clinically (68%). Eighteen remained unchanged (20%). Four further deteriorated (4%). In 16 cases (18%) a shunt implantation was subsequently required.
In all, the endoscopic approach can be considered safe and successful in children of less than 14 years of age. However, the success rate seems to be lower than in adults. However, because of a very limited surgical risk, the endoscopic approach represents the first choice approach for the authors if possible.