title: Neuroendoscopic trans-third ventricle approach for lesions of the ventral brainstem surface.
abstract: Due to the establishment in recent years of neuroendoscopic third ventriculostomy (ETV), it has become possible during ETV to observe the ventral brainstem surface--particularly the prepontine cistern--in a minimally invasive manner via the third ventricular base with a neuroendoscope. As an adaptation of that technique in this study, we investigated a neuroendoscopic trans-third ventricle approach (ETTVA), which accesses lesions of the ventral brainstem surface with a neuroendoscope inserted via the stoma of the third ventricular floor. Our study included 6 cases, including one case each of neurenteric cyst, chordoma, pontine glioma (astrocytoma), ecchordosis physaliphora, endodermal cyst, and cystic schwannoma. Surgical operations performed by ETTVA included 3 cases of tumor resection, 2 cases of tumor biopsy, and 1 case of cyst puncture and aspiration. There were no complications accompanying ETTVA. Out of the 6 cases, only 1 required additional surgical treatment following ETTVA surgery. In the other 5 cases, no additional surgical procedures were performed. This study showed that ETTVA allowed access to the prepontine cistern quickly and in a minimally invasive manner. In selected cases, ETTVA can offer a new approach to these lesions.
authors.affiliation: Department of Neurosurgery, Tokyo Medical University, Tokyo, Japan. mikit@qa2.so-net.ne.jp
authors.forename: T
authors.initials: T
authors.lastname: Miki
authors.forename: N
authors.initials: N
authors.lastname: Nakajima
authors.forename: J
authors.initials: J
authors.lastname: Akimoto
authors.forename: J
authors.initials: J
authors.lastname: Wada
authors.forename: J
authors.initials: J
authors.lastname: Haraoka
mesh_terms: D000328:Adult; D000368:Aged; D001254:Astrocytoma / Q000601:surgery*; D020295:Brain Stem Neoplasms / Q000601:surgery*; D002648:Child; D002817:Chordoma / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D044583:Neuroendoscopy / Q000379:methods*; D019635:Neurosurgical Procedures / Q000379:methods; D012189:Retrospective Studies; D020542:Third Ventricle / Q000601:surgery*; D016896:Treatment Outcome; D014696:Ventriculostomy / Q000379:methods*; D055815:Young Adult