Nakahara Kuniaki, Shimizu Satoru, Utsuki Satoshi, Suzuki Sachio, Oka Hidehiro, Yamada Masaru, Kan Shinichi, Fujii Kiyotaka
Department of Neurosurgery and Radiology, Kitasato University School of Medicine, 1-15-1 Kitasato, Sagamihara, Kanagawa, 228-8555, Japan.
Childs Nerv Syst. 2009 Jan;25(1):91-4. doi: 10.1007/s00381-008-0709-2. Epub 2008 Sep 4.
The authors present the difference of shortening the ventricular shunt catheter associated with growth of the cranium between the frontal and parieto-occipital access, a key for long patency of the shunt implanted in children.
Our retrospective study included 28 children. In group A (n=9), the catheter was inserted through a frontal burr hole and in group B (n=19), through a parieto-occipital burr hole. To compare changes that occurred in the interval between the time of insertion and follow-up in the length of the ventricular catheter in the cranium and to assess displacement of the burr used for catheter entry.
The results show that ventricular catheter shortening and burr-hole displacement were more pronounced in group A.
This study documents that insertion of the ventricular catheter via the frontal route in children resulted in a higher incidence of shortening due to greater displacement of the burr hole adjacent to the coronal suture. Therefore, we recommend that the parieto-occipital route be used to maintain long-term shunt function.
作者阐述了额部入路和顶枕部入路在与颅骨生长相关的脑室分流导管缩短方面的差异，这是儿童植入分流装置长期通畅的关键。
我们的回顾性研究纳入了28名儿童。A组（n = 9）通过额部钻孔插入导管，B组（n = 19）通过顶枕部钻孔插入导管。比较插入时与随访期间脑室导管在颅骨内长度的变化，并评估导管插入部位钻孔的移位情况。
结果显示，A组脑室导管缩短和钻孔移位更为明显。
本研究证明，儿童经额部途径插入脑室导管，由于冠状缝附近钻孔移位更大，导致缩短发生率更高。因此，我们建议采用顶枕部途径以维持分流装置长期功能。
