Fourth Ventricular Outflow Obstruction in an Infant with Ileal Atresia and Laryngomalacia: Endoscopic Management
Fourth ventricle outflow obstruction (FVOO) is a rare cause of obstructive hydrocephalus. In this study, we described a case of idiopathic FVOO with ileal atresia and laryngomalacia which was managed with endoscopic third ventriculostomy (ETV) and re-endoscopy. We also described the techniques of fe...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Thieme Medical Publishers, Inc.
2020-06-01
|
| Series: | Indian Journal of Neurosurgery |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1710104 |
| _version_ | 1819074622464720896 |
|---|---|
| author | Forhad H. Chowdhury Mohammod Raziul Haque Jalal Uddin Mohammod Rumi Mohammod Samsul Arifin |
| author_facet | Forhad H. Chowdhury Mohammod Raziul Haque Jalal Uddin Mohammod Rumi Mohammod Samsul Arifin |
| author_sort | Forhad H. Chowdhury |
| collection | DOAJ |
| description | Fourth ventricle outflow obstruction (FVOO) is a rare cause of obstructive hydrocephalus. In this study, we described a case of idiopathic FVOO with ileal atresia and laryngomalacia which was managed with endoscopic third ventriculostomy (ETV) and re-endoscopy. We also described the techniques of fenestration of Liliequist membrane and partial removal of arachnoid membrane over dorsum sella (DS) to prevent closure of fenestration and recurrence of hydrocephalus. The patient was a 4-month-old infant presented with progressively increasing head size, feeding difficulty, respiratory distress, and tense fontanel. The infant had a history of laparotomy for ileal atresia. CT scan showed panventriculomegaly due to FVOO. ETV with fenestration of Liliequist membrane was done on emergency basis. After operation, the patient improved clinically and radiologically. Four weeks later, the patient returned with recurrent hydrocephalus. Endoscopic reoperation showed closure of fenestration in arachnoid membrane (Lilieqiest membrane). Endoscopic refenestration with partial excision of arachnoid on DS was done. The patient again recovered radiologically and clinically till last follow-up. In idiopathic FVOO, ETV with wide fenestration of Liliequist membrane, preferably with partial removal of arachnoid on DS, may be very useful in treating hydrocephalus (HCP) and preventing recurrent HCP even in infants. |
| first_indexed | 2024-12-21T18:12:27Z |
| format | Article |
| id | doaj.art-fc97241a822d4cd9ae11d39d253aff8d |
| institution | Directory Open Access Journal |
| issn | 2277-954X 2277-9167 |
| language | English |
| last_indexed | 2024-12-21T18:12:27Z |
| publishDate | 2020-06-01 |
| publisher | Thieme Medical Publishers, Inc. |
| record_format | Article |
| series | Indian Journal of Neurosurgery |
| spelling | doaj.art-fc97241a822d4cd9ae11d39d253aff8d2022-12-21T18:54:45ZengThieme Medical Publishers, Inc.Indian Journal of Neurosurgery2277-954X2277-91672020-06-0190321922410.1055/s-0040-1710104Fourth Ventricular Outflow Obstruction in an Infant with Ileal Atresia and Laryngomalacia: Endoscopic ManagementForhad H. Chowdhury0Mohammod Raziul Haque1Jalal Uddin Mohammod Rumi2Mohammod Samsul Arifin3Department of Neurosurgery, National Institute of Neurosciences and Hospital, Dhaka, BangladeshDepartment of Neurosurgery, Dhaka Medical College Hospital, Dhaka, BangladeshDepartment of Neurosurgery, National Institute of Neurosciences and Hospital, Dhaka, BangladeshDepartment of Neurosurgery, Ibn Sina Specialized Hospital, Dhanmondi, Dhaka, BangladeshFourth ventricle outflow obstruction (FVOO) is a rare cause of obstructive hydrocephalus. In this study, we described a case of idiopathic FVOO with ileal atresia and laryngomalacia which was managed with endoscopic third ventriculostomy (ETV) and re-endoscopy. We also described the techniques of fenestration of Liliequist membrane and partial removal of arachnoid membrane over dorsum sella (DS) to prevent closure of fenestration and recurrence of hydrocephalus. The patient was a 4-month-old infant presented with progressively increasing head size, feeding difficulty, respiratory distress, and tense fontanel. The infant had a history of laparotomy for ileal atresia. CT scan showed panventriculomegaly due to FVOO. ETV with fenestration of Liliequist membrane was done on emergency basis. After operation, the patient improved clinically and radiologically. Four weeks later, the patient returned with recurrent hydrocephalus. Endoscopic reoperation showed closure of fenestration in arachnoid membrane (Lilieqiest membrane). Endoscopic refenestration with partial excision of arachnoid on DS was done. The patient again recovered radiologically and clinically till last follow-up. In idiopathic FVOO, ETV with wide fenestration of Liliequist membrane, preferably with partial removal of arachnoid on DS, may be very useful in treating hydrocephalus (HCP) and preventing recurrent HCP even in infants.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1710104hydrocephalusfourth ventricle outflow obstructionendoscopic third ventriculostomyre-endoscopic procedure |
| spellingShingle | Forhad H. Chowdhury Mohammod Raziul Haque Jalal Uddin Mohammod Rumi Mohammod Samsul Arifin Fourth Ventricular Outflow Obstruction in an Infant with Ileal Atresia and Laryngomalacia: Endoscopic Management Indian Journal of Neurosurgery hydrocephalus fourth ventricle outflow obstruction endoscopic third ventriculostomy re-endoscopic procedure |
| title | Fourth Ventricular Outflow Obstruction in an Infant with Ileal Atresia and Laryngomalacia: Endoscopic Management |
| title_full | Fourth Ventricular Outflow Obstruction in an Infant with Ileal Atresia and Laryngomalacia: Endoscopic Management |
| title_fullStr | Fourth Ventricular Outflow Obstruction in an Infant with Ileal Atresia and Laryngomalacia: Endoscopic Management |
| title_full_unstemmed | Fourth Ventricular Outflow Obstruction in an Infant with Ileal Atresia and Laryngomalacia: Endoscopic Management |
| title_short | Fourth Ventricular Outflow Obstruction in an Infant with Ileal Atresia and Laryngomalacia: Endoscopic Management |
| title_sort | fourth ventricular outflow obstruction in an infant with ileal atresia and laryngomalacia endoscopic management |
| topic | hydrocephalus fourth ventricle outflow obstruction endoscopic third ventriculostomy re-endoscopic procedure |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1710104 |
| work_keys_str_mv | AT forhadhchowdhury fourthventricularoutflowobstructioninaninfantwithilealatresiaandlaryngomalaciaendoscopicmanagement AT mohammodraziulhaque fourthventricularoutflowobstructioninaninfantwithilealatresiaandlaryngomalaciaendoscopicmanagement AT jalaluddinmohammodrumi fourthventricularoutflowobstructioninaninfantwithilealatresiaandlaryngomalaciaendoscopicmanagement AT mohammodsamsularifin fourthventricularoutflowobstructioninaninfantwithilealatresiaandlaryngomalaciaendoscopicmanagement |