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Neuroendoscopic Procedures and Challenges (Paperback)
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Neuroendoscopic Procedures and Challenges (Paperback)
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In 1910, L'Espinasse performed the first neurosurgical endoscopic
procedure for choroid plexus electrocoagulation in an infant with
hydrocephalus, by use of a cystoscope. One infant was successfully
treated. Walter Dandy used an endoscope to perform an unsuccessful
choroid plexectomy in 1922. The next year, Mixter, using a
urethroscope, performed the first successful endoscopic third
ventriculostomy in a 9-month-old girl with obstructive
hydrocephalus. In 1935, Scarff reported his initial results about
endoscopic third ventriculostomy using a novel endoscope. His
ventriculoscope had an irrigation system to prevent
intraventricular collapse and was equipped with a flexible unipolar
probe. In 1952, Nulsen and Spitz began the era of ventricular
cerebrospinal fluid (CSF) shunting, marking the end of the initial
era of neuroendoscopy. This dark period for neuroendoscopy
continued until 1970s. However, in this period image capabilities
of endoscopes improved with technological developments. In 1978,
Vries demonstrated that ETVs were technically feasible using a
fiberoptic endoscope to treat patients with hydrocephalus. In 1990,
Jones and colleagues described a 50% shunt-free success rate for
ETV in 24 patients with various forms of hydrocephalus. Four years
later, the same group reported an improved success rate of 61% in a
series of 103 patients. Currently, ETV is primarily used to treat
obstructive hydrocephalus due to benign aqueductal stenosis or
compressive periaqueductal mass lesions. Modern shunt-free success
rates range from 80 to 95%. The field of neuroendoscopy has
extended beyond ventricular procedures. The endoscope is currently
used for all types of neurosurgically treatable diseases such as
obstructive hydrocephalus, various intraventricular lesions,
hypothalamic hamartomas, craniosynostosis, skull base tumors, and
spinal lesions and rare subtypes of hydrocephalus. With the
evolution of surgical techniques, endoscopy has emerged as a
suitable alternative to many instances of more invasive methods.
Surgeons using a neuroendoscope can perform many complex operations
through very small incisions. Nowadays, neurosurgeons prefer
neuroendoscopic surgery for many different lesions because of less
damage to healthy tissue, low complication rate and excellent
results. Neuroendoscopic surgery is a specialty within neurosurgery
and requires a neurosurgeon to undergo specialized training. In
this book, we focused on neuroendoscopic procedures and challenges.
We have created this book with the hope that it can be a guide for
neurosurgeons who are interested in neuroendoscopic interventions.
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