Loh J K, Howng S L
Division of Neurosurgery, Department of Surgery, Kaohsiung Medical University, Kaohsiung, Taiwan.
Kaohsiung J Med Sci. 2000 Oct;16(10):510-6.
Long-term extracranial shunting for hydrocephalus has numerous drawbacks related to shunt malfunction and infection. The outcomes have been very disappointing in some cases. We have treated twenty one patients with obstructive hydrocephalus, without mortality or morbidity, using a flexible endocope to perform third ventriculostomy. Favorable outcomes were achieved in 95.2% of the cases. Our results are superior to those previously reported. Most of the patients remained shunt independent after treatment and had obtained long-term stabilization. Flexible endoneurosurgical management is simple and safe, and it allows in situ observation and performance of biopsies. Therefore, in patients with obstructive hydrocephalus due to aqueductal stenosis, endoscopic third ventriculostomy should be seriously considered as the primary surgical management.
脑积水的长期颅外分流术存在许多与分流器故障和感染相关的缺点。在某些情况下，结果非常令人失望。我们使用软性内镜进行第三脑室造瘘术治疗了21例梗阻性脑积水患者，无死亡或发病情况。95.2%的病例取得了良好的结果。我们的结果优于先前报道的结果。大多数患者治疗后无需分流，且获得了长期稳定。软性神经外科治疗简单且安全，可进行原位观察和活检。因此，对于因导水管狭窄导致的梗阻性脑积水患者，应认真考虑将内镜下第三脑室造瘘术作为主要的手术治疗方法。
