Abstract
PurposeNeuroendoscopic procedures for treatment of term and preterm newborn infants, such as endoscopic lavage for posthemorrhagic hydrocephalus, are gaining popularity despite sparse data. This single-institution report compiles all neuroendoscopic surgical procedures performed in neonates during a 10-year period.MethodsCharts and electronic records were reviewed of all consecutive newborns who underwent a neuroendoscopic procedure before reaching a postmenstrual age of 44 weeks between 09/2010 and 09/2020. Available documentation was reviewed regarding the performed neuroendoscopic procedure, course of disease, complications, and all re-operations throughout the first year of life.ResultsDuring the 10-year study period, 116 infants (median gestational age at birth: 29 1/7 weeks) underwent a total of 153 neuroendoscopic procedures (median postmenstrual age at surgery: 35 0/7 weeks). The most common indication at the time of the neuroendoscopic procedures (n = 153) was intraventricular hemorrhage (IVH, n = 119), intraventricular infection (n = 15), congenital malformation (n = 8), isolated 4th ventricle (n = 7), multiloculated hydrocephalus (n = 3), and tumor (n = 1). Thirty-eight of 116 children (32.8%) underwent 43 operative revisions after 153 neuroendoscopic procedure (28.1%). Observed complications requiring surgical revision were secondary infection (n = 11), CSF fistula (n = 9), shunt dysfunction (n = 8), failure of ETV (n = 6), among others. 72 children (62%) of 116 children required permanent CSF diversion via a shunt. The respective shunt rates per diagnosis were 47 of 80 (58.8%) for previously untreated IVH, 11 of 13 (84.6%) for intraventricular infection. Shunt survival rate for the first year of life was 74% for the whole cohort.ConclusionThe experience with this large cohort of neonates demonstrates the feasibility of neuroendoscopic technique for the treatment of posthemorrhagic or postinfectious hydrocephalus. Rate and type of complications after neuroendoscopic procedures were within the expected range. Assessing the potential long-term benefits of neuroendoscopic techniques has to await results of ongoing studies.
Highlights
The application of neuroendoscopic surgery has gained widespread utilization to treat a wide variety of intracranial and intraspinal pathologies especially in pediatric neurosurgical practice
The underlying primary condition leading to subsequent neurosurgical treatment was intraventricular hemorrhage (IVH, n = 102), intraventricular infection (IVI, n = 7), cysts (n = 3), congenital malformations (n = 3), and tumor (n = 1)
The main indications to consider a neuroendoscopic procedure in the evaluated age group of premature and neonatal children are related to intraventricular hemorrhage and subsequently developing hydrocephalus
Summary
The application of neuroendoscopic surgery has gained widespread utilization to treat a wide variety of intracranial and intraspinal pathologies especially in pediatric neurosurgical practice. The spectrum of performed neurosurgical interventions in this age group is limited and usually related to disturbed CSF circulation. Because of the fragility of the treated children, temporary treatment options — e.g., insertion of ventricular access device (VAD) or ventriculosubgaleal shunts (VSGS) — are applied to bridge the time until definite surgeries can be performed. Despite the complex condition of neonates, the application of neuroendoscopic techniques has been introduced and gained some popularity for specific indications [5]. The primary application is to treat intraventricular hemorrhage and subsequent. No comprehensive series of possible neuroendoscopic surgical indications in this age group has been described
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
