Article
Reliability of neuroendoscopic treatment in aqueductal stenosis related hydrocephalus
Zuverlässigkeit neuroendoskopischer Therapieverfahren beim Hydrozephalus mit Aqueduktstenose
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Published: | April 11, 2007 |
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Objective: Various neuroendoscopic techniques have been described for the treatment of hydrocephalus caused by aqueductal stenosis. The question was asked whether aqueductoplasty (AP) or third ventriculostomy (ETV) is more reliable in this setting.
Methods: Since 1993 69 patients with primary aqueduct stenosis have been treated with neuroendoscopy at our institution. Aqueductoplasty (group I) was performed in 20 and ETV (group II) in 36 patients. Both procedures (group III) were simultaneously done in 13 patients. The average age was 43.8 (group I), 36.6 (group II) and 33.2 (group III).
Results: There was a mean follow-up period of 36.3, 46.2 and 29.3 months (I-III). In group I, eight patients presented with restenosis of the aqueduct. Eight ETV and five Re-AP were performed in these patients. In five patients of Group II, a restenosis of the aqueduct or ventriculostoma was found. In this group three Re-ETV’s were performed. Group III verified a reclosure rate of the stoma in 11.1% (4 patients). Again, Re-ETV’s were done. There was a need for shunt implantation in 5.7% of all patients (I: 0; II: 3; III: 1).
Conclusions: There was a higher rate of restenosis of the aqueduct after AP than of the ventriculostoma after ETV. Therefore, we recommend performing ETV instead of AP in patients with hydrocephalus caused by aqueduct stenosis.