Endoscopic Strategy in Surgical Treatment of Adult Idiopathic Bilateral Occlusion of the Foramen of Monro and Review of the Literature
Background Endoscopic approach has been used increasingly for the surgical treatment of adult idiopathic bilateral occlusion of the foramen of Monro (AIOFM). The aim of this study is to assess and compare the results of this strategy with other surgical methods of treating AIOFM. Methods A retrospective study was performed to identify patients with AIOFM treated in our department from 2012 to 2017. We also performed a search of the literature to detect any case of AIOFM reported from 1980 to 2017 to provide a comprehensive assessment of the treatment of this condition. AIOFM was classified as 4 groups, including bilateral true stenosis of the foramen of Monro (FM), bilateral membrane occlusion of the FM, unilateral true FM stenosis with septum deviation, and unilateral membrane occlusion of the FM with septum deviation all assessed and discussed separately. Results We found four patients with AIOFM surgically treated with endoscopic procedures in our department between the years of 2012 to 2017 with an excellent outcome. Fourteen studies were also detected during our review of the literature, most of which involved treatment with neuroendoscopy and excellent outcomes. We found that neuroendoscopy could be the first-line strategy to treat all 4 types of AIOFM. Conclusions Endoscopic strategy is associated with excellent outcomes and fewer risks in treatment of all types of AIOFM; it is also less invasive compared with ventriculoperitoneal shunt insertion. Highlights Adult idiopathic bilateral occlusion of the Foramen of Monro could be best managed with endoscopic procedure. Endoscopic procedure is associated with lower risks compared to other surgical approaches. Endoscopic strategy is associated with a low risk of surgical morbidity and mortality.
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