Effect of endoscopic third ventriculostomy in treating severe obstructive hydrocephalus in premature infant

Abstract

Objective To discuss the treatment and the clinical effect of endoscopic third ventriculostomy on severe obstructive hydrocephalus in premature infant. Methods Eleven patients were operated, ultrasound, CT and MRI showed severe obstructive hydrocephalus and cerebral spinal fluid absorption was normal.The technique was that endoscope was inserted through the foramen of Monro into the third ventricle, then perforating the floor of the third ventriculostomy.Comparison before and after surgery of ventricular system ultrasonic measurement about the change of lateral ventricle and the MRI and CT imaging changes were performed.The complications, operation effect and security were observed.The bailey baby scale and Peabody movement function scale was used to assess the patient's neurologic system status. Results The follow-up time was 6 months and 6 years after operation, an excellent operative result was got in 9 cases.The ventricular width of 1 patient was mild ventriculomegaly, but stayed stabilily.No change of ventricular width was found in 1 case.Additional shunt were needed in 1 case.No severe complications were found.The left and right lateral ventricle measured by ultrasonic before operation were (9.60±3.52)mm and (8.63±3.10)mm before operation, and (5.50±2.20) mm and (4.90±2.70) mm after operation.The 11 cases of lateral ventricle side edema were disappeared, the follow-up time in 9 cases were more than 12 months, obstructive hydrocephalus clinical symptoms were relieved. Conclusions Ventricular mirror operation significantly improve severe hydrocephalic short and long-term poor prognosis, it is a safe, effective and less complications of minimally invasive surgery. Key words: Obstructive hydrocephalus; Ventriculoscope; Third ventriculostomy; Preterm infant