Jones R F, Kwok B C, Stening W A, Vonau M
Sydney Children's Hospital, Australia.
Eur J Pediatr Surg. 1996 Dec;6 Suppl 1:5-6. doi: 10.1055/s-2008-1071027.
Twenty-five patients have undergone this procedure at our unit. These constitute 25% of our total experience with endoscopic third ventriculostomy (4). In the patients under 6 months of age, only one out of 11 patients has had a successful long-term result despite initial good fenestration of the floor of the third ventricle. These patients were selected on the basis of their adequate third ventricular size and a relatively slowly progressive hydrocephalus. Fourteen patients had a ventriculostomy performed instead of shunt revision. In 13 patients this has been a success long term. All of these patients had a Heyer-Schulte valve with antisiphon device installed for months, or more often, years, prior to the third ventriculestomy. We believe that the difference in these two groups is due to a very poor cerebrospinal fluid(CSF)-resorptive capability in patients immediately after back closure due to the prior venting of CSF into the amniotic sac. The absorptive capacity seems to improve with the passage of time in our patients who have had a shunt system that maintains a relatively normal intracranial pressure and thus contributes to the development of the patient's CSF-absorptive system.
我们科室已有25例患者接受了这一手术。这些患者占我们内镜下第三脑室造瘘术总经验的25%（4）。在6个月以下的患者中，11例患者中只有1例获得了成功的长期效果，尽管最初第三脑室底部的造瘘良好。这些患者是根据其第三脑室大小合适以及脑积水进展相对缓慢而挑选出来的。14例患者接受了脑室造瘘术而非分流管修复术。其中13例患者长期效果良好。所有这些患者在接受第三脑室造瘘术之前，都已安装带有防虹吸装置的Heyer-Schulte瓣膜数月，甚至更常见的是数年。我们认为，这两组患者存在差异的原因是，由于之前脑脊液排入羊膜囊，在关闭背部后立即出现脑脊液吸收能力极差的情况。在我们那些拥有能维持相对正常颅内压的分流系统从而有助于患者脑脊液吸收系统发育的患者中，吸收能力似乎会随着时间推移而改善。
