Endoscopic Treatment of Ventricular or Paraventricular Lesions – Shiraz Experience

Abstract

Background: The aim of this study is to demonstrate our primary experience in endoscopic treatment of obstructive hydrocephalus caused by intracranial lesions, fenestration and biopsy of cystic lesions and excision of intra-ventricular masses.

Materials and Methods: Between July 2012 and October 2013, in Nemazee Hospital, Shiraz, a descriptive study on a series of patients with intracranial lesions and hydrocephalus was established. Transventricular endoscopies were performed by a single team to fenestrate, biopsy or excision of cystic lesions as a primary treatment or as a first stage operation to facilitate the second microsurgical resection.

Results: This study was carried out with 35 patients by the mean age of 17 year-old (Range from 6 months to 70 years) including 19 females and 16 males. Some of most important cases were as below: Six cases of craniopharyngioma with large intraventricular cystic component and hydrocephalus had endoscopic cyst fenestration and septum plucidotomy as a first stage operation that followed with sub frontal approach in 4 patients. Combination of endoscopic surgery with microsurgical partial tumor resection and decompression made the second surgery easier with minimal post-operative complications. Five patients with solid-cystic optic pathway glioma had cyst fenestration and biopsy followed by chemoradiotherapy without any operation related complications.

Conclusion: We found our policy useful in management of ventricular and paraventricular lesions with hydrocephalus especially in decision making for suprasellar solid-cystic masses.

 Keywords: Transventricular endoscopy, Hydrocephalus, Suprasellar tumor