Neuroendoscopy in Paediatric

Neurosurgery
 Craniosynostosis
• Principles of endoscopic treatment of
Craniosynostosis :
1. To operate in very young infants less than 3
months of age
2. Allowing Brain growth to correct deformities
3. To make sure that Sutures of Skull base not
involved by doing imaging studies
4. Post Procedure helmets to be applied.
• These endoscopic
procedures for treatment
of Craniosynostosis have
become definitive
procedures today.
• Advantage : Decreases
need for blood
transfusion when
compareed to Open
surgical techniques like
Strip Craniectomy
 Endscopic Treatment for
Hydrocephalus
• 1. Optimize Shunt Function ( Proximal
Catheter Position )
• 2. CSF Diversion (ETV )
• 3. Reestablish CSF flow as in Aqueductoplasty
/Foramioplasty
• 4.Decrease CSF Production ( Choroid Plexus
Fulguration )
• 5.Septostomy (Isolated Lateral Venricle
Hydrocephalus )
Role of Neuroendoscopy in Paediatric
Hydrocephalus
1. Noncommunicating Hydrocephalus ETV
2. Neuroendoscopic Lavage in cases of IVH in
neonates for irigation of ventricles and
aspiration of blod clots
3. Multiloculated hydrocephalus due to post
infectious/post hemorrhagic etiology
4. Removal of Recalcitrant Shunt
5. Cyst Fenestration . ( Posterior fossa
Arachnoid Cyst )
 Neuroendoscopy Role in Paediatric
Epilepsy Surgery
• Early Surgical intervention is recommended in
infant with catastrophic epilepsy to prevent
development arrest and regression
• Early Studies have shown Endoscopic Corpus
Callosotomy has shown equal results to open
seizure ablation procedures in comparable
paediatric group with complications like less
blood loss and less soft tissue swelling.