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Updated: Jun 9, 2025
Author Spotlight: A Single-Entry Point Endoscopic Intraventricular Approach for Third Ventriculostomy and Pineal Biopsy
Published on: June 28, 2024
The Utility of Neuroendoscopic Approach for Pineal Region Lesions: Single-Centre Experience
Onur Ozgural1, Eyup Bayatli, Halit Anil Eray
1Ankara University, School of Medicine, Department of Neurosurgery, Ankara, Türkiye.
Aim:
To investigate the treatment approaches and follow-up data of patients with pineal region tumours at our institution.
Material And Methods:
A retrospective study was planned to evaluate patients who diagnosed with a pineal mass between 2019 and 2022 whether incidentally or symptomatically. All patients were evaluated regarding their radiological findings, clinical, labrotary and radiological outcomes of surgery if any performed, intraoperative and postoperative pathological diagnoses, and radiological and symptomatic follow-up results for at least one year.
Results:
A total of 16 patients were grouped into 2; intervention and conservation groups, respectively. Nine out of 16 patients received intervention (surgery with or without ionising radiation therapy) and remained 7 followed up without intervention. Seven patients in the intervention group were found to have triventricular hydrocephalus, and one had tetraventricular hydrocephalus. Endoscopic approach was the preferred surgical intervention in all operated patients which was conventional endoscopic third ventriculostomy (ETV) via a right-sided frontal burr hole. Five patients required a simultaneous external ventricular drain. Neuronavigation was used in all the procedures.
Conclusion:
Neuroendoscopic intervention is a relatively safe, effective, low-cost initial procedure with low morbidity rates and enables patients to return daily life rapidly. Neuroendoscopy is the best approach for simultaneously providing tissue sampling and diversion of cerebrospinal fluid via ETV or septostomy in hydrocephalic patients with tumours in the pineal region.
Insights
Neuroendoscopic surgery offers a safe and effective initial treatment for pineal region tumors, with rapid recovery. This approach is ideal for tissue sampling and managing hydrocephalus in affected patients.
Area of Science:
- Neurosurgery
- Oncology
- Neurology
Background:
- Pineal region tumors present unique management challenges.
- Hydrocephalus is a common complication requiring timely intervention.
Purpose of the Study:
- To evaluate treatment strategies and follow-up outcomes for pineal region tumors.
- To assess the efficacy and safety of neuroendoscopic interventions.
Main Methods:
- Retrospective study of 16 patients diagnosed between 2019-2022.
- Evaluation of radiological, clinical, and pathological data.
- Analysis of surgical (endoscopic third ventriculostomy with or without CSF diversion) and non-surgical management.
Main Results:
- Nine patients underwent intervention, primarily endoscopic third ventriculostomy (ETV) with neuronavigation.
- Seven patients had triventricular hydrocephalus, and one had tetraventricular hydrocephalus.
- Low morbidity and rapid return to daily life observed post-intervention.
Conclusions:
- Neuroendoscopic intervention is a safe, effective, and cost-efficient initial treatment for pineal region tumors.
- It facilitates simultaneous tissue sampling and cerebrospinal fluid diversion in hydrocephalic patients.
- Neuroendoscopy is recommended for managing hydrocephalus associated with pineal region tumors.
