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  • Title: Endoscopic aqueductoplasty in the treatment of aqueductal stenosis.
    Author: da Silva LR, Cavalheiro S, Zymberg ST.
    Journal: Childs Nerv Syst; 2007 Nov; 23(11):1263-8. PubMed ID: 17676325.
    Abstract:
    OBJECTIVE: Endoscopic aqueductoplasty is an option of treatment of obstructive hydrocephalus caused by aqueductal stenosis. We report on our experience with this endoscopic technique. MATERIALS AND METHODS: Eighteen patients with primary or secondary aqueductal stenosis underwent endoscopic aqueductoplasty (EA) with or without stenting between July 2004 and January 2007. EA, EA with a stent, EA with endoscopic third ventriculostomy (ETV), and EA with stenting in addition to ETV were performed in eight, five, three, and two patients, respectively. A repeat endoscopic procedure was done in one patient. EA with a stent was performed in case 1, 8 months after first endoscopic procedure. In four cases, aqueductoplasty with stent was performed through a suboccipital approach. RESULTS: There were no deaths due to the neuroendoscopic procedures. All of the patients showed improvement or resolution of their preoperative symptoms, although in case 1 a new endoscopic procedure was performed: EA with a stent. CONCLUSION: Cerebral aqueductoplasty is an effective and successful treatment for membranous and/or short-segment stenosis of the sylvian aqueduct. Endoscopic aqueductoplasty candidates must be selected very carefully but longer follow-up periods are necessary to evaluate long-term aqueductal patency after aqueductoplasty.
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