Hellwig Dieter, Grotenhuis Joachim Andreas, Tirakotai Wuttipong, Riegel Thomas, Schulte Dirk Michael, Bauer Bernhard Ludwig, Bertalanffy Helmut
Department of Neurosurgery, Philipps University Marburg, Baldingerstrasse, 35033, Marburg, Germany.
Neurosurg Rev. 2005 Jan;28(1):1-34; discussion 35-8. doi: 10.1007/s10143-004-0365-2. Epub 2004 Nov 27.
The indications for neuroendoscopy are not only constantly increasing, but even the currently accepted indications are constantly being adjusted and tailored. This is also true for one of the most frequently used neuroendoscopic procedures, the endoscopic 3rd ventriculostomy (ETV) for obstructive hydrocephalus. ETV has gained popularity and widespread acceptance during the past few years, but little attention has been paid to the techniques of the procedure. After a short introduction describing the history of ETV, an overview is given of all the different techniques that have been and still are employed to open the floor of the 3rd ventricle. The spectrum of indications for ETV has been widely enlarged over the last years. Initially, the use of this procedure was restricted to patients older than 2 years, to patients with an obvious triventricular hydrocephalus, and to those with a bulging, translucent floor of the 3rd ventricle. Nowadays, indications include all kinds of obstructive hydrocephalus but also communicating forms of hydrocephalus. The results of endoscopic procedures in treating these pathologies are given under special consideration of shunt technologies. In summary, from the review of the publications since the first ETV performed by Mixter in 1923, this technique is the treatment of choice for obstructive hydrocephalus caused by different etiologies and is an alternative to cerebrospinal fluid shunt application.
神经内镜的适应证不仅在持续增加，甚至目前公认的适应证也在不断调整和细化。对于最常用的神经内镜手术之一，即用于梗阻性脑积水的内镜下第三脑室造瘘术（ETV）来说也是如此。在过去几年中，ETV已得到普及并被广泛接受，但该手术技术却很少受到关注。在简短介绍ETV的历史之后，本文将概述所有已采用和仍在使用的打开第三脑室底部的不同技术。在过去几年中，ETV的适应证范围已大幅扩大。最初，该手术仅适用于2岁以上、患有明显三脑室脑积水且第三脑室底部膨出、透光的患者。如今，适应证包括各种梗阻性脑积水以及交通性脑积水。在内镜手术治疗这些病症的结果方面，本文特别考虑了分流技术。总之，回顾自1923年米克斯特首次实施ETV以来的相关出版物可知，该技术是治疗由不同病因引起的梗阻性脑积水的首选方法，也是脑脊液分流术的替代方案。
