Top

Child's Nervous System

Published in:

01-03-2009 | Original Paper

Measurements of burr-hole localization for endoscopic procedures in the third ventricle in children

Authors: H. Knaus, A. Abbushi, K. T. Hoffmann, K. Schwarz, H. Haberl, U. W. Thomale

Published in: Child's Nervous System | Issue 3/2009

Abstract

Objective

In a retrospective study, we measured the localization for the burr hole for neuroendoscopic procedures in the third ventricle, which are determined by anatomical landmarks like the foramen of Monro (FM) and the respective targets.

Patients and methods

In 48 children, thin-sliced T2-weighted magnetic resonance images were analyzed within an imaging software tool to determine the trajectory between the FM to the floor of the third ventricle (F3V) or the entrance of the sylvian aqueduct (SA). The crossing point at the skull convexity defined the entry points. Coordinates are given relative to nasion and midline. A mean virtual entry point to reach both targets was compared to the burr-hole localization used in the respective surgeries. The tissue shift at the FM was quantified for the trajectories.

Results

The entry point to reach the F3V or the SA measured 119.7 ± 26.4 mm (to nasion)–20.5 ± 11.5 mm (to midline) and 57.4 ± 26.5–18.8 ± 8.3 mm, respectively. The virtual mean entry point to reach both targets was located at 86.5 ± 25.3–20.9 ± 9.8 mm. There was a statistical difference in the entry point localization relative to nasion of the virtual mean trajectory compared with the burr-hole localization used in these patients. The tissue shift at the level of the FM using the mean virtual trajectory was significantly lower than by using the actual burr hole to the SA.

Conclusions

Planning an optimal burr-hole localization is important in neuroendoscopic procedures in children, especially where the target is located around the sylvian aqueduct.

Feng H, Huang G, Liao X, Fu K, Tan H, Pu H, Cheng Y, Liu W, Zhao D (2004) Endoscopic third ventriculostomy in the management of obstructive hydrocephalus: an outcome analysis. J Neurosurg 100(4):626–633PubMed

Schroeder HW, Oertel J, Gaab MR (2004) Endoscopic aqueductoplasty in the treatment of aqueductal stenosis. Child's Nerv Syst 20(11–12):821–827CrossRef

Ray P, Jallo GI, Kim RY, Kim BS, Wilson S, Kothbauer K, Abbott R (2005) Endoscopic third ventriculostomy for tumor-related hydrocephalus in a pediatric population. Neurosurg Focus 19(6):E8PubMedCrossRef

Cinalli G, Salazar C, Mallucci C, Yada JZ, Zerah M, Sainte-Rose C (1998) The role of endoscopic third ventriculostomy in the management of shunt malfunction. Neurosurgery 43(6):1323–1327PubMedCrossRef

Boschert J, Hellwig D, Krauss JK (2003) Endoscopic third ventriculostomy for shunt dysfunction in occlusive hydrocephalus: long-term follow up and review. J Neurosurg 98(5):1032–1039PubMed

Hellwig D, Grotenhuis A, Tirakotai W (2003) A cost-effectiveness analysis of endoscopic third ventriculostomy. Neurosurgery 52(6):1506–1507PubMedCrossRef

Beems T, Grotenhuis JA (2004) Long-term complications and definition of failure of neuroendoscopic procedures. Child's Nerv Syst 20(11–12):868–877CrossRef

Murshid WR (2000) Endoscopic third ventriculostomy: towards more indications for the treatment of non-communicating hydrocephalus. Minim Invasive Neurosurg 43(2):75–82PubMedCrossRef

Brockmeyer D, Abtin K, Carey L, Walker ML (1998) Endoscopic third ventriculostomy: an outcome analysis. Pediatr Neurosurg 28(5):236–240PubMedCrossRef

10.

Jones RF, Kwok BC, Stening WA, Vonau M (1994) The current status of endoscopic third ventriculostomy in the management of non-communicating hydrocephalus. Minim Invasive Neurosurg 37(1):28–36PubMedCrossRef

11.

Schroeder HW, Gaab MR (1999) Endoscopic aqueductoplasty: technique and results. Neurosurgery 45(3):508–515PubMedCrossRef

12.

Fukuhara T, Vorster SJ, Luciano MG (2000) Risk factors for failure of endoscopic third ventriculostomy for obstructive hydrocephalus. Neurosurgery 46(5):1100–1111PubMedCrossRef

13.

Kanner A, Hopf NJ, Grunert P (2000) The “optimal” burr hole position for endoscopic third ventriculostomy: results from 31 stereotactically guided procedures. Minim Invasive Neurosurg 43(4):187–189PubMedCrossRef

14.

Abtin K, Thompson BG, Walker ML (1998) Basilar artery perforation as a complication of endoscopic third ventriculostomy. Pediatr Neurosurg 28(1):35–41PubMedCrossRef

15.

Ersahin Y, Arslan D (2007) Complications of endoscopic third ventriculostomy. Childs Nerv Syst 23(2):143–150PubMedCrossRef

16.

Kim BS, Jallo GI, Kothbauer K, Abbott IR (2004) Chronic subdural hematoma as a complication of endoscopic third ventriculostomy. Surg Neurol 62(1):64–68PubMedCrossRef

17.

Schroeder HW, Oertel J, Gaab MR (2007) Endoscopic treatment of cerebrospinal fluid pathway obstructions. Neurosurgery 60(ONS Suppl 1):44–52

18.

Hellwig D, Grotenhuis JA, Tirakotai W, Riegel T, Schulte DM, Bauer BL, Bertalanffy H (2004) Endoscopic third ventriculostomy for obstructive hydrocephalus. Neurosurg Rev 28(1):1–34PubMed

19.

Hopf NJ, Grunert P, Fries G, Resch K, Perneczky A (1999) Endoscopic third ventriculostomy: outcome analysis of 100 consecutive procedures. Neurosurgery 44(4):795–804PubMedCrossRef

20.

St George E, Natarajan K, Sgouros S (2004) Changes in ventricular volume in hydrocephalic children following successful endoscopic third ventriculostomy. Childs Nerv Syst 20(11–12):834–838PubMedCrossRef

21.

Morelli D, Pirotte B, Lubansu A, Detemmerman D, Aeby A, Fricx C, Berré J, David P, Brotchi J (2005) Persistent hydrocephalus after early surgical management of posterior fossa tumors in children: is routine preoperative endoscopic third ventriculostomy justified? J Neurosurg 103(3 Suppl):247–252PubMed

22.

Scarrow AM, Levy EI, Pascucci L, Albright AL (2000) Outcome analysis of endoscopic III ventriculostomy. Childs Nerv Syst 16(7):442–444PubMedCrossRef

23.

Gangemi M, Donati P, Maiuri F, Longatti P, Godano U, Mascari C (1999) Endoscopic third ventriculostomy for hydrocephalus. Minim Invasive Neurosurg 42(3):128–132PubMedCrossRef

24.

Grunert P, Charalampaki P, Hopf N, Filippi R (2003) The role of third ventriculostomy in the management of obstructive hydrocephalus. Minim Invasive Neurosurg 46(1):16–21PubMedCrossRef

25.

Buxton N, Macarthur D, Mallucci C, Punt J, Vloeberghs M (1998) Neuroendoscopic third ventriculostomy in patients less than 1 year old. Pediatr Neurosurg 29(2):73–76PubMedCrossRef

26.

Fritsch MJ, Mehdorn M (2002) Endoscopic intraventricular surgery for treatment of hydrocephalus and loculated CSF space in children less than one year of age. Pediatr Neurosurg 36(4):183–188PubMedCrossRef

27.

Fritsch MJ, Kienke S, Manwaring KH, Mehdorn M (2004) Endoscopic aqueductoplasty and interventriculostomy for the treatment of isolated fourth ventricle in children. Neurosurgery 55(2):372–377PubMedCrossRef

28.

Teo C, Rahman S, Boop FA, Cherny B (1996) Complications of endoscopic neurosurgery. Childs Nerv Syst 12(5):284–253CrossRef

29.

Riegel T, Hellwig D, Bauer BL, Mennel HD (1994) Endoscopic anatomy of the third ventricle. Acta Neurochir Suppl 61:54–56PubMed

30.

Choi JU, Kim DS, Kim SH (1999) Endoscopic surgery for obstructive hydrocephalus. Yonsei Medical Journal 40(6):600–607PubMed

31.

Singh D, Gupta V, Goyal A, Singh H, Sinha S, Singh AK, Kumar S (2003) Endoscopic third ventriculostomy in obstructed hydrocephalus. Neurology India 51(1):39–42PubMed

32.

O'Brien DF, Javadpour M, Collins DR, Spennato P, Mallucci CL (2005) Endoscopic third ventriculostomy: an outcome analysis of primary cases and procedures performed after ventriculoperitoneal shunt malfunction. J Neurosurg 103(5 Suppl):393–400PubMed

33.

Yamini B, Refai D, Rubin CM, Frim DM (2004) Initial endoscopic management of pineal region tumors and associated hydrocephalus: clinical series and literature review. J Neurosurg 100(5 Suppl Pediatrics):437–441PubMed

34.

O'Brian D, Hayhurst C, Pizer B, Mallucci CL (2006) Outcomes in patients undergoing single-trajectory endoscopic third ventriculostomy and endoscopic biopsy for midline tumors presenting with obstructive hydrocephalus. J Neurosurg 105(3 Suppl):219–226

Title: Measurements of burr-hole localization for endoscopic procedures in the third ventricle in children
Authors: H. Knaus
A. Abbushi
K. T. Hoffmann
K. Schwarz
H. Haberl
U. W. Thomale
Publication date: 01-03-2009
Publisher: Springer-Verlag
Published in: Child's Nervous System / Issue 3/2009
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI: https://doi.org/10.1007/s00381-008-0712-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Measurements of burr-hole localization for endoscopic procedures in the third ventricle in children

Abstract

Objective

Patients and methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Patients and methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 3/2009

Medulloblastoma: clinicopathologic evaluation of 42 pediatric cases

Endovascular treatment of a neonate with dural arteriovenous fistula and other features suggestive of cerebrofacial arteriovenous metameric syndromes

Craniopharyngioma and hypothalamic obesity in children

Cerebral blood flow autoregulation during intracranial hypertension: a simple, purely hydraulic mechanism?

Microsurgical study of the interpeduncular cistern and its communication with adjoining cisterns

Is radical surgery necessary to head and neck inflammatory myofibroblastic tumor (IMT) in children?