Septostomy and foraminoplasty

1024 1024 Jonathan Roth

Septostomy and foraminoplasty

Diagnosis: Hydrocephalus due to atresia of Foramen of Monro
  • 35-year-old woman
  • Headaches for 1 month, papilloedema
  • MR scan at presentation: hydrocephalus, large lateral ventricles, small third ventricle
  • Endoscopic septostomy and foraminoplasty
EQUIPMENT USED
  • Storz Oi Handy Pro Endoscope
SURGICAL TIPS
  • Pre-coronal burr hole, placed at the level of the lateral canthus (more lateral than usual), for the septostomy
  • Study the septal vein anatomy at the MR scans
  • Aim at the upper half of the septum to avoid injury to the contralateral fornix, which is not visible from the ipsilateral side of approach
  • Blunt perforation of the membrane covering the foramen of Monro with the balloon
Pre op
CONTRIBUTOR

Jonathan Roth

Pediatric Neurosurgeon, Sourasky Medical Center, Tel Aviv, Israel

All cases by: Jonathan Roth