Endoscopic third ventriculostomy and simultaneous tumor biopsy in pineal region tumors using the “Single Burr Hole” technique: An analysis of 34 cases
Gagandeep Attri1, Jaskaran Singh Gosal1, Deepak Khatri1, Kuntal Kanti Das1, Kamlesh Singh Bhaisora1, Anant Mehrotra1, Jayesh Sardhara1, Arun Kumar Srivastava1, Sanjay Behari1, Sushila Jaiswal2, Awadhesh Kumar Jaiswal1
1 Department of Neurosurgery, SGPGIMS, Lucknow, Uttar Pradesh, India
2 Department of Pathology, SGPGIMS, Lucknow, Uttar Pradesh, India
Awadhesh Kumar Jaiswal,
Department of Neurosurgery, SGPGIMS, Raibareli Road, Lucknow - 226 014, Uttar Pradesh
Source of Support: None, Conflict of Interest: None
Background: Pineal region tumors often present with hydrocephalus. Endoscopic third ventriculostomy (ETV) and simultaneous tumor biopsy remain a minimally invasive procedure offering both diagnostic and therapeutic advantages in the management of these tumors. However, different operative techniques have been described in the literature. Aim: The aim is to study the ETV success rate, diagnostic rate of simultaneous tumor biopsy, complications, and follow-up of patients of pineal region tumors managed with ETV and simultaneous tumor biopsy using the single burr hole technique. Methods: The study was performed by retrospectively reviewing the records of patients of pineal region tumors managed by simultaneous ETV and tumor biopsy using a “single burr hole” technique from January 2012 to December 2019. Results: Thirty-four patients (22 males and 12 females) with a mean age of 28.7 years were analyzed. ETV was successful in relieving hydrocephalus in 29 (87.8%) patients. Three patients needed a ventriculoperitoneal shunt, and one required Ommaya reservoir placement for persistent hydrocephalus. Histological diagnosis was successfully established in 26 (78.8%) patients. There were two procedure-related mortalities. Two patients underwent craniotomy and tumor excision subsequently. Radiotherapy was given to 11 patients, and 9 patients were managed by observation alone. The mean follow-up of our study was 15.8 months. Conclusions: Simultaneous ETV and tumor biopsy using a single burr hole technique is a safe, minimally invasive procedure for the management of pineal region tumors.