Objective:
To describe a microsurgical alternative to endoscopic third ventriculocisternostomy.
Methods:
Two children with shunt-dependent hydrocephalus and multiple shunt revisions were considered candidates for third ventriculocisternostomy (TVS). Because of slit ventricles, an endoscopic approach was not possible and, therefore, both patients received a microsurgical TVS by a supraorbital approach.
Results:
In both cases, microsurgical TVS was successful and the patients became shunt free.
Conclusion:
Microsurgical TVS by a supraorbital craniotomy is a viable alternative to endoscopic TVS in selected cases.