Neuronavigation-guided endoscopy for intraventricular tumors in adult patients without hydrocephalus.
BACKGROUND
Intraventricular endoscopic operations are usually undertaken in patients with an enlarged ventricular system that provides good access to the ventricles, proper anatomic orientation and safety of maneuvers within the ventricles.


OBJECTIVE
The preliminary assessment of the feasibility of endoscopic procedures in cases occurring without hydrocephalus.


METHODS
Eleven patients with intraventricular tumor diagnosed in neuroimaging studies were included in the study. None of these cases was accompanied by hydrocephalus. Surgery was performed with a rigid neuroendoscope using a neuronavigation system. The purpose of the operation was tumor removal or histological verification.


RESULTS
The colloid cyst of the third ventricle was removed in 5 patients. In 1 patient a glial-derived tumor adjacent to the interventricular foramen was partially resected. In 1 case a tumor of the lateral ventricle was totally removed, and in another case the resection of such a tumor was partial. In 2 cases, a biopsy of the tumor of the posterior portion of the third ventricle was undertaken, while in 1 case the biopsy was abandoned due to the risk of injury of structures surrounding interventricular foramen. There were no intraoperative or postoperative complications. None of the patients developed hydrocephalus in the long-term follow-up. The results of treatment in the study group did not differ from those obtained in patients operated on with hydrocephalus.


CONCLUSIONS
The presence of hydrocephalus is not necessary to perform endoscopic surgery. However, in each case it should be preceded by a thorough analysis of the feasibility of the endoscopic procedure and should be supported by a neuronavigation system.
Department of Neurosurgery and Neurotraumatology, Jagiellonian University, Medical College, Krakow, Poland.
Krzysztof
K
Stachura
Department of Neurosurgery and Neurotraumatology, Jagiellonian University, Medical College, Krakow, Poland.
Ewelina
E
Grzywna
intraventricular tumors; narrow ventricular system; neuroendoscopy; neuronavigation