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2017 ; 60
(3
): 327-334
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Transcortical Endoscopic Surgery for Intraventricular Lesions
#MMPMID28490160
Kim MH
J Korean Neurosurg Soc
2017[May]; 60
(3
): 327-334
PMID28490160
show ga
To review recent advances in endoscopic techniques for treating intraventricular
lesions via transcortical passage. Articles in PubMed published since 2000 were
searched using the keywords 'endoscopy,' 'endoscopic,' and 'neuroendoscopic.' Of
these articles, those describing intraventricular lesions were reviewed.
Suprasellar arachnoid cysts (SACs) can be treated with ventriculo-cystostomy (VC)
or ventriculo-cysto-cisternostomy (VCC). VCC showed better results compared to
VC. Procedure type, fenestration size, stent placement, and aqueductal patency
may affect SAC prognosis. Colloid cysts can be managed using a transforaminal
approach (TA) or a transforaminal-transchoroidal approach (TTA). However, TTA may
result in better exposure compared to TA. Intraventricular cysticercosis can be
cured with an endoscopic procedure alone, but if pericystic inflammation and/or
ependymal reaction are seen, third ventriculostomy may be recommended. Tumor
biopsies have yielded successful diagnosis rates of up to 100%, but tumor
location, total specimen size, endoscope type, and vigorous coagulation on the
tumor surface may affect diagnostic accuracy. An ideal indication for tumor
excision is a small tumor with friable consistency and little vascularity. Tumor
size, composition, and vascularity may influence a complete resection. SACs and
intraventricular cysticercosis can be treated successfully using endoscopic
procedures. Endoscopic procedures may represent an alternative to surgical
options for colloid cyst removal. Solid tumors can be safely biopsied using
endoscopic techniques, but endoscopy for tumor resection still results in
considerable challenges.