Farin Azadeh, Aryan Henry E, Ozgur Burak M, Parsa Andrew T, Levy Michael L
Department of Neurosurgery, University of Southern California (USC), Los Angeles, California, USA.
J Clin Neurosci. 2006 Aug;13(7):763-70. doi: 10.1016/j.jocn.2005.11.029. Epub 2006 May 26.
Among patients with idopathic aqueductal stenosis or impedance of cerebrospinal fluid (CSF) flow in the posterior fossa due to tumour, endoscopic fenestration of the floor of the third ventricle creates an alternative route for CSF flow to the subarachnoid space via the prepeduncular cistern. By reestablishing CSF flow, this procedure dissipates any pressure gradient on midline structures. This may obviate the need for traditional CSF shunt diversion techniques in such settings. Currently, endoscopic third ventriculostomy is indicated in approximately 25% of patients with hydrocephalus and can be performed instead of shunt placement. Appropriate patients are those with aqueductal stenosis (10%), obstructive tumours (10%), and obstructive cysts (5%). Additional recent data suggest the favorability of third ventriculostomy over shunt implantation in additional patient cohorts. Operative technique is discussed.
在患有特发性导水管狭窄或因肿瘤导致后颅窝脑脊液（CSF）流动受阻的患者中，第三脑室底部的内镜开窗术为脑脊液通过脚间池流入蛛网膜下腔创造了一条替代途径。通过重建脑脊液流动，该手术消除了中线结构上的任何压力梯度。在这种情况下，这可能无需传统的脑脊液分流技术。目前，约25%的脑积水患者适合进行内镜下第三脑室造瘘术，且可替代分流置管术。合适的患者包括导水管狭窄患者（10%）、阻塞性肿瘤患者（10%）和阻塞性囊肿患者（5%）。最近的其他数据表明，在其他患者群体中，第三脑室造瘘术比分流植入术更具优势。文中讨论了手术技术。
