Fenestration of intraventricular cysts using a flexible, steerable endoscope

Multiloculated hydrocephalus with multiple intraventricular septae due to meningitis associated with ventriculitis and other CSF containing intraventricular cysts can be treated by endoscopic fenestration. Seven patients with various CSF containing intraventricular cysts were treated using a flexible steerable endoscope and the argon laser. The experience using several currently available steerable endoscopes for treatment of this neurosurgical problem is reviewed. Emphasis is placed on the use of the laser for cyst fenestration. Successful decompression of the ventricular cyst(s) was accomplished in five cases with the endoscope alone. Craniotomy was required in two patients in order to complete cyst fenestration. It is the author's impression that laser assisted ventriculoscopy with steerable flexible endoscopes is an alternative and oftentimes superior method of treating CSF containing cysts within the lateral ventricles of hydrocephalic patients. Steerable flexible endoscopes designed specifically for neurosurgical use are needed.