T. Riegel et al., Operative management of third ventriculostomy in cases of thickened, non-translucent third ventricular floor: Technical note, MIN IN NEUR, 44(2), 2001, pp. 65-69
Today, endoscopic third ventriculostomy is an established operative modalit
y in occlusive hydrocephalus. The elemental step in third ventriculostomy i
s the perforation of the floor of the third ventricle. Especially with a th
ickened third ventricular floor, anatomical orientation can be disturbed an
d perforation of third ventricular floor technically difficult. The combina
tion of a neuronavigation system with an endoscope provides interactive ima
ge-guided neuroendoscopy. Exact planning of the approach is thus possible a
nd the ideal trajectory to the target area can be determined. We have combi
ned interactive neuronavigation and intraoperative fluoroscopy for incorpor
ating real-time feedback to optimize endoscopy in patients with a thickened
third ventricular floor selected for third ventriculostomy.