A single-pass tunneling technique for CSF shunting procedures

Michael A. Sandquist, Nathan R. Selden

    Research output: Contribution to journalArticlepeer-review

    8 Scopus citations

    Abstract

    Implantation of ventriculoperitoneal shunts in the precoronal position is generally accomplished using a retroauricular incision for subcutaneous tunneling. Retroauricular incisions can be associated with complications, including cerebrospinal fluid leak and shunt infection. We describe a technique for 'single-pass' shunt tunneling from frontal to abdominal incisions and our initial results in a consecutive, prospective series of 15 children (age 2 days to 5 years). Eleven patients presented with congenital hydrocephalus (including 5 with myelomeningocele and 3 with posthemorrhagic hydrocephalus) and 4 with hydrocephalus secondary to central nervous system (CNS) tumors. The average length of clinical follow-up was 6 months (range 1-13 months). There were no perioperative or long-term complications of the single-pass technique. Nine of the 11 patients with congenital hydrocephalus are currently well without any further medical or surgical intervention. Two underwent shunt revision for proximal obstruction, with an intact distal system. Three of the 4 patients with hydrocephalus secondary to CNS tumor suffered secondary shunt complications during periods of severe neutropenia resulting from chemotherapy (6 weeks to 6 months after shunt insertion). For primary ventriculoperitoneal shunt insertion in infants and young children, the single-pass tunneling technique is safe and avoids one source of complications.

    Original languageEnglish (US)
    Pages (from-to)254-257
    Number of pages4
    JournalPediatric Neurosurgery
    Volume39
    Issue number5
    DOIs
    StatePublished - 2003

    Keywords

    • CSF leak
    • Hydrocephalus
    • Infection
    • Ventriculoperitoneal shunt

    ASJC Scopus subject areas

    • Pediatrics, Perinatology, and Child Health
    • Surgery
    • Clinical Neurology

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