Endoscopic Management of Third Ventricular Tumours

Abstract

When analyzing the results of various approachesto the third ventricle, finds that in all techniques mentioned satisfactory results. What would indicate thetechnique to be used, therefore, would be the exacttopography of the tumor within the third ventricle,respecting the anatomical limitations of each approachand the surgeon’s familiarity with the chosen access. The endoscopic technique is improving its results andestablishing itself as a reliable method of choice formany neurosurgeons, to access the pathologies of thethird ventricle.It would require prospective studies that couldcompare the main techniques of approach to the thirdventricle, which actually show superiority of one technique over another. Endoscopy for colloid cysts is a reasonable alternative to microsurgery.Surgery is needed for the symptomatic colloid cyst,prophylactic surgery in asymptomatic and younger patientsneeds to be balanced by surgical risk, the size of the colloid cystmay not be an important consideration against endoscopicresection. The criteria for endoscopic resection of intraventricularsolid tumors are; tumor size, clinical history and location ofthe lesion. Presently, endoscopy for solid intraventricular tumorsis limited to small (< 2 cm) and avascular tumors. For pinealregion tumor resection and ETV, the best approach is individualizedbased on the third ventricular environment. Endoscopicequipment used in the management of intraventriclular tumorsutilizes 2D optics, scope dimensions are currently acceptable,while larger portals, greater versatility, improved hemostasisare all needed. Scope holders and navigational guidance playvariable roles. Further development is a must for bi-manual dissectionand tissue ablation, and eagerly awaited. (Qiao 2011)