Enchev Yavor, Oi Shizuo
Division of Pediatric Neurosurgery, Jikei University Hospital, Women's and Children's Medical Center, Tokyo, Japan.
Neurosurg Rev. 2008 Jul;31(3):249-62. doi: 10.1007/s10143-008-0131-y. Epub 2008 May 8.
The treatment of hydrocephalus nowadays is still a challenge for neurosurgery. Neuroendoscopy is a valuable alternative of the CSF shunts in hydrocephalus management. Because of the complicated and always changeable pathophysiology of hydrocephalus, the history of the endoscopic treatment of hydrocephalus is also a history of severe frustrations, great expectations, and significant achievements. The historical milestones and state of the art of neuroendoscopic treatment of hydrocephalus are reviewed for each of its surgical techniques: choroid plexus coagulation, third ventriculostomy, aqueductoplasty, septostomy, foraminal plasty of the foramen of Monro, and foraminal plasty of the foramen of Magendie. The future trends of neuroendoscopic treatment of hydrocephalus such as robotics, image-guided neuroendoscopic surgical techniques, treatment "in utero", application of stem cell therapy, implementation of new technological solutions, and so on are discussed in the light of the approaching end of the century of neuroendoscopy.
如今,脑积水的治疗仍是神经外科面临的一项挑战。神经内镜检查是脑积水治疗中脑脊液分流术的一种有价值的替代方法。由于脑积水的病理生理学复杂且多变,脑积水的内镜治疗史也是一部充满严重挫折、巨大期望和重大成就的历史。本文针对神经内镜治疗脑积水的每种手术技术,即脉络丛凝固术、第三脑室造瘘术、导水管成形术、隔膜造口术、Monro孔成形术和Magendie孔成形术,回顾了其历史里程碑和当前技术水平。鉴于神经内镜时代即将结束,文中还讨论了脑积水神经内镜治疗的未来趋势,如机器人技术、图像引导神经内镜手术技术、“子宫内”治疗、干细胞疗法的应用、新技术解决方案的实施等。