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Selective Neuroendoscopic Resection of the Choroid Plexus as an Alternative Technique for Optimizing the Standard Endoscopic Approach to Hydrocephalus

In the past four decades, enormous advances have been made in the neuroendoscopic techniques, along with improvement of illumination, and the development of effective instruments. As a result, endoscopic third ventriculostomy (ETV) and choroid plexus cauterization (CPC) have become consolidated tech...

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Autores principales: Ferreira Furtado, Leopoldo Mandic, Da Costa Val Filho, José Aloysio, Moura de Sousa, Camila, Dantas, François, Holliday, Julia Braga
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7681940/
https://www.ncbi.nlm.nih.gov/pubmed/33240735
http://dx.doi.org/10.7759/cureus.11618
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author Ferreira Furtado, Leopoldo Mandic
Da Costa Val Filho, José Aloysio
Moura de Sousa, Camila
Dantas, François
Holliday, Julia Braga
author_facet Ferreira Furtado, Leopoldo Mandic
Da Costa Val Filho, José Aloysio
Moura de Sousa, Camila
Dantas, François
Holliday, Julia Braga
author_sort Ferreira Furtado, Leopoldo Mandic
collection PubMed
description In the past four decades, enormous advances have been made in the neuroendoscopic techniques, along with improvement of illumination, and the development of effective instruments. As a result, endoscopic third ventriculostomy (ETV) and choroid plexus cauterization (CPC) have become consolidated techniques for the treatment of hydrocephalus. In particular, endoscopic cauterization of the choroid plexus has increased the effectiveness of hydrocephalus treatment in combination with ETV. In the past decade, the use of flexible endoscopes has enabled surgeons to resect even the temporal segment of the choroid plexus at the lateral ventricles, which has increased the success of treatment. In this technical note, we describe CPC with the use of a rigid endoscope, which we used to selectively disconnect the glomus of the choroid plexus, in addition to choroid plexus coagulation, as an alternative way to facilitate ETV. This new procedure optimized the visualization of the choroid plexus and the temporal horn and prevented additional difficulties in coagulation of this mobile region of the choroid plexus in selected patients. To achieve the best outcome, avoid bleeding, and optimize the standard technique, it was important to recognize both the classical anatomic structure of the choroid plexus and some variations, and previous expertise in ETV and CPC were necessary. We demonstrate that resection of the glomus of the choroid plexus in selected patients is safe and feasible.
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spelling pubmed-76819402020-11-24 Selective Neuroendoscopic Resection of the Choroid Plexus as an Alternative Technique for Optimizing the Standard Endoscopic Approach to Hydrocephalus Ferreira Furtado, Leopoldo Mandic Da Costa Val Filho, José Aloysio Moura de Sousa, Camila Dantas, François Holliday, Julia Braga Cureus Pediatrics In the past four decades, enormous advances have been made in the neuroendoscopic techniques, along with improvement of illumination, and the development of effective instruments. As a result, endoscopic third ventriculostomy (ETV) and choroid plexus cauterization (CPC) have become consolidated techniques for the treatment of hydrocephalus. In particular, endoscopic cauterization of the choroid plexus has increased the effectiveness of hydrocephalus treatment in combination with ETV. In the past decade, the use of flexible endoscopes has enabled surgeons to resect even the temporal segment of the choroid plexus at the lateral ventricles, which has increased the success of treatment. In this technical note, we describe CPC with the use of a rigid endoscope, which we used to selectively disconnect the glomus of the choroid plexus, in addition to choroid plexus coagulation, as an alternative way to facilitate ETV. This new procedure optimized the visualization of the choroid plexus and the temporal horn and prevented additional difficulties in coagulation of this mobile region of the choroid plexus in selected patients. To achieve the best outcome, avoid bleeding, and optimize the standard technique, it was important to recognize both the classical anatomic structure of the choroid plexus and some variations, and previous expertise in ETV and CPC were necessary. We demonstrate that resection of the glomus of the choroid plexus in selected patients is safe and feasible. Cureus 2020-11-22 /pmc/articles/PMC7681940/ /pubmed/33240735 http://dx.doi.org/10.7759/cureus.11618 Text en Copyright © 2020, Ferreira Furtado et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Pediatrics
Ferreira Furtado, Leopoldo Mandic
Da Costa Val Filho, José Aloysio
Moura de Sousa, Camila
Dantas, François
Holliday, Julia Braga
Selective Neuroendoscopic Resection of the Choroid Plexus as an Alternative Technique for Optimizing the Standard Endoscopic Approach to Hydrocephalus
title Selective Neuroendoscopic Resection of the Choroid Plexus as an Alternative Technique for Optimizing the Standard Endoscopic Approach to Hydrocephalus
title_full Selective Neuroendoscopic Resection of the Choroid Plexus as an Alternative Technique for Optimizing the Standard Endoscopic Approach to Hydrocephalus
title_fullStr Selective Neuroendoscopic Resection of the Choroid Plexus as an Alternative Technique for Optimizing the Standard Endoscopic Approach to Hydrocephalus
title_full_unstemmed Selective Neuroendoscopic Resection of the Choroid Plexus as an Alternative Technique for Optimizing the Standard Endoscopic Approach to Hydrocephalus
title_short Selective Neuroendoscopic Resection of the Choroid Plexus as an Alternative Technique for Optimizing the Standard Endoscopic Approach to Hydrocephalus
title_sort selective neuroendoscopic resection of the choroid plexus as an alternative technique for optimizing the standard endoscopic approach to hydrocephalus
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7681940/
https://www.ncbi.nlm.nih.gov/pubmed/33240735
http://dx.doi.org/10.7759/cureus.11618
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