The role of repeat endoscopic third ventriculostomy after failure of the initial procedure.

摘要

Endoscopic third ventriculostomy (ETV) is replacing, in many neurosurgical centers, valve-regulated shunts as the initial treatment of obstructive hydrocephalus or at the time of shunt failure, nevertheless only few authors, until now, have addressed the role of repeat ETV (re-ETV) after failure of the initial procedure. Since the earliest experiences with ETV, obstruction of the stoma has been recognized as one of the possible reasons for failure and reopening of ostomy by repeating the procedure has been proposed as an alternative to shunt placement. Obliteration of the orifice after a successful ETV is probably a natural healing process that can happen in some patients with a certain degree of subjectivity. More intriguing are, instead, patients who benefited from a primary ETV for long periods of time, underwent re-ETV but failed to improve!