Flexible Neuroendoscope Research Articles

Improved safety of neuroendoscopic third ventriculostomy by using an operative Doppler ultrasound probe

In this paper the authors describe the use of a Doppler device, originally built for intravascular use, that is passed through a flexible neuroendoscope during a neuroendoscopic third ventriculostomy (NTV) procedure to treat for hydrocephalus. There was no morbidity associated with the use of this Doppler probe, and the procedure was not significantly lengthened. The Doppler probe was very accurate in locating the position of the basilar artery tip and assured the safety of NTV.

Flexible Neuroendoscopy for Percutaneous Treatment of Intraventricular Lesions in the Absence of Hydrocephalus

A procedure with a flexible fiberoptic neuroendoscope was applied to a series of patients with small lesions in the lateral ventricle, not associated with hydrocephalus. The maneuverability of the flexible neuroendoscope allows the surgeon to work in narrow spaces of the lateral ventricle avoiding surgical trauma to surrounding neural structures. The safety and accuracy of this procedure depend upon how available working space is obtained in the undilated ventricles. Both shaft-rotation and tip-flexion of the flexible neuroendoscope are available for adjusting it to the wider axis in each region of the lateral ventricle and for dealing with the intraventricular lesions. Three patients with a small intraventricular lesion, two with arachnoid cysts and one with subependymal hematoma, underwent such a procedure successfully. It is concluded that this neuroendoscopic procedure provides benefits to the treatment of small intraventricular lesions regardless of the size of the cerebral ventricles.

The radiographic restoration of the ventricular system after third ventriculostomy.

Ten adult patients were treated by third ventriculostomy for idiopathic aqueductal stenosis. Idiopathic aqueductal stenosis was diagnosed according to MR imaging; aqueductal stenosis secondary to tumor, hemorrhage, and/or infection was excluded. Following a third ventriculostomy under a flexible neuroendoscope, all patients were reviewed at 1, 3, 6, 12, and 24 months, and MR images with ventricular measurements were repeated for evaluation of the radiographic restoration of the ventricular system. The ventricular structures arranged in order of restoration were the size of the III ventricle, the upward deviation of the brain stem, and the size of the lateral ventricle in response to third ventriculostomy. The restoration of the whole ventricle steadied within two years. Our results contribute new information regarding restoration of the ventricular system under aqueductal stenosis and produce evidence that third ventriculostomy is a reasonable treatment based upon the patient's physiological condition.

Neuroendoscopic technique for the operative treatment of septated syringomyelia.

The management of septated, chambered syringomyelia has until now been problematic because the usual operative methods cannot secure drainage of all chambers of the cavity. The development of a flexible neuroendoscope affords the possibility to perforate the septa under visual control which subdivide the cavity. We present our experiences with 11 cases of septated syringomyelia, which have been operated upon using a flexible neuroendoscope.