A single-pass tunneling technique for CSF shunting procedures

Michael A. Sandquist, Nathan Selden

Research output: Contribution to journalArticle

6 Citations (Scopus)

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

Fingerprint

Hydrocephalus
Ventriculoperitoneal Shunt
Central Nervous System Neoplasms
Cerebrospinal Fluid Shunts
Meningomyelocele
Neutropenia
Drug Therapy
Infection

Keywords

  • CSF leak
  • Hydrocephalus
  • Infection
  • Ventriculoperitoneal shunt

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

Cite this

A single-pass tunneling technique for CSF shunting procedures. / Sandquist, Michael A.; Selden, Nathan.

In: Pediatric Neurosurgery, Vol. 39, No. 5, 2003, p. 254-257.

Research output: Contribution to journalArticle

Sandquist, Michael A. ; Selden, Nathan. / A single-pass tunneling technique for CSF shunting procedures. In: Pediatric Neurosurgery. 2003 ; Vol. 39, No. 5. pp. 254-257.
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