761 Long-term Results of Endoscopic Aqueductoplasty

INTRODUCTION: Endoscopic aqueductoplasty is an option in the treatment of obstructive hydrocephalus caused by aqueductal stenoses. We report on our experience with this endoscopic technique, focusing on indications, operative technique, and results. METHODS: A series of 39 endoscopic aqueductoplasties was performed in 33 patients harboring a hydrocephalus caused by aqueductal stenosis. In 13 patients, a third ventriculostomy was performed simultaneously. RESULTS: There was no endoscopy-related mortality. One aqueductoplasty had to be abandoned. The mean follow-up period was 40 months (range, 1 to 97 mo). In seven patients, reclosure of the restored aqueduct required an endoscopic revision. In 25 patients (76%), the hydrocephalus-related symptoms resolved or improved. The condition was unchanged in eight patients. Four patients needed to be shunted. The ventricles decreased in size in 22 patients (67%), were larger in two, and unchanged in the remaining nine patients. CONCLUSION: Endoscopic aqueductoplasty is a treatment option in patients with hydrocephalus caused by membranous aqueductal stenosis. Unfortunately, the reclosure rate is higher than initially expected. More experience and longer follow-up is necessary to determine the value of endoscopic aqueductoplasty in the treatment of hydrocephalus caused by aqueductal stenosis.