ENDOSCOPY FOR ACHIEVEMENT OF SHUNT-INDEPENDENT CONDITION IN TREATMENT OF SLIT VENTRICLE SYNDROME

Abstract

Objective: Objective: To demonstrate the results of neuroendoscopic operations for achievement of shunt-independent condition in treatment of slit ventricle syndrome. Methods: Forty-three cases were considered: adult patients aged 18 years and over – 5 (11.63%), and children aged 0-17 years – 38 (88.37%). Pediatric patients were divided into the following age groups: under 1 year – 6 (13.95%); 1-2 years – 7 (16.28%); 2-17 years – 25 (58.14%). The interval between operations was an average of 2 years 6 months (from 1 week to 16 years), and the period of observation after surgery – an average of 41.8 months (from 1 week to 100 months). Results: In children under 1 year, the efficiency was 83.3%; 1-2 years old – 71.4%; 2-17-years old – 92%; 60% of adult patients aged 18 and over. The effectiveness of operations performed using standard rigid endoscopes was 72.1%, and using a semi-rigid needle-shaped endoscope – 95.2%. In total, the overall efficiency of the ETV, aqueductoplasty, choroid plexus coagulation, cystocysternostomy, septostomy, ventricular stenting, revision and reconstruction of VPS, plasty and stenting of Foramen of Magendie and Lyushka, independently from the age of the patients, type of endoscopes was 83%. In 68.3% of cases shunt-independent state was achieved. Conclusions: Endoscopic methods have shown their high effectiveness in the treatment of patients with slit ventricle syndrome and other complications of hydrocephalus. Using a more advanced modern endoscopic technique, such as a semi-rigid needle endoscope in our case, allows to restore CSF circulation even in the most distal sections of the interpeduncular and prepontine cisterns, as well as safely remove and install a ventricular catheter with minimal trauma to surrounding structures and achieve a shunt-independent state. Keywords: Slit ventricle syndrome, endoscopic ventriculocysternostomy, obstructive hydrocephalus, semi-rigid needle-shaped neuroendoscope, aqueductoplasty, septostomy.