Success Rate of Endoscopic Third Ventriculostomy (ETV) in Non-Communicating Hydrocephalus in Pediatric Age Group
DOI:
https://doi.org/10.36552/pjns.v25i2.544Keywords:
Endoscopic Third Ventriculostomy, Non-Communicating Hydrocephalus, Pediatric age groups, Cerebrospinal FluidAbstract
Objective: To evaluate success rate of the endoscopic third Ventriculostomy (ETV) in non-communicating type of hydrocephalus in pediatric age group.
Material and Methods: This study was carried in the department of neurosurgery at Liaquat university hospital, Jamshoro in which an endoscopic third Ventriculostomy procedure was performed in patients (n = 55) with non-communicating hydrocephalus from October 2016 to April 2017. Post-operative follow-up was done on the 15th day post-operative to assess clinical and radiological improvement.
Results: 55 patients were included in this study, 26 (47.27%) males and 29 (52.73%) females. The mean age was 3.96 years. The most common etiology was aqueductal stenosis 28 (50.90%) patients followed by posterior fossa tumors in 18 (32.72%) patients. The operative technique was successful in 41 (74.55%) patients. Out of 41 successful patients, 34 (82.92%) patients had clinical as well as radiological improvement whereas 7 (17.07%) patients had clinical improvement only.
Conclusion: The success rate of ETV was 74.55% in the non-communicating hydrocephalus in the pediatric age group in our study. Endoscopic third Ventriculostomy is an effective treatment for non-Communicating hydrocephalus in pediatric age groups by diversion of CSF intracranially. This procedure provides shunt freedom and can be used alternative to shunts in pediatric age groups with non-communicating hydrocephalus.
References
2. Ul Haq MI, Khan SA, Raja RA, Ahmed E. Efficacy of endoscopic third ventriculostomy in non-communicating hydrocephalus. J Ayub Med Coll Abbottabad 2012;24(2) :144-6.
3. Deopujari CE, Karmarkar VS, Shaikh ST. Endoscopic Third Ventriculostomy: Success and Failure. J Korean Neurosurg Soc. 2017;60(3):306-314.
4. Demerdash A, Rocque BG, Johnston J, Rozzelle CJ, Yalcin B, Oskouian R, et al. Endoscopic third ventriculostomy: A historical review. Br J Neurosurg. 2017;31(1):28-32.
5. Greitz D. Paradigm shift in hydrocephalus research in legacy of Dandy’s pioneering work: rationale for third ventriculostomy in communicating hydrocephalus. Child Ner Syst. 2007;23(5):487.
6. Jallo GI, Kothbauer KF, Abbott IR. Endoscopic third ventriculostomy. Neurosurg Focus. 2005;19(6):1-4.
7. Baykan N, Isbir O, Gerçek A, Dagçnar A, Özek MM. Ten years of experience with pediatric neuroendoscopic third ventriculostomy: features and perioperative complications of 210 cases. J Neurosurg Anesthesiol. 2005;17(1):33-7.
8. Moorthy R, Rajshekhar V. Endoscopic third ventriculostomy for hydrocephalus: a review of indications, outcomes, and complications. Neurol India. 2011;59(6):848.
9. Sarmast A, Khursheed N, Ramzan A, et al. Endoscopic Third Ventriculostomy in Noncommunicating Hydrocephalus: Report on a Short Series of 53 Children. Asian J Neurosurg. 2019;14(1):35-40.
10. Kulkarni AV, Drake JM, Kestle JR, Mallucci CL, Sgouros S, Constantini S, et al. Endoscopic third ventriculostomy vs cerebrospinal fluid shunt in the treatment of hydrocephalus in children: a propensity score–adjusted analysis. Neurosurg. 2010;67(3):588-93.
11. Choudhary A, Sobti S, Zambre S, Bhaskar S. Endoscopic third ventriculostomy in failed ventriculoperitoneal shunt in pediatric population. Asian J Neurosurg 2020;15(4):937-40.
12. Ali M, Usman M, Khan Z, Khan KM, Hussain R, Khanzada K. Endoscopic third ventriculostomy for obstructive hydrocephalus. J Coll Physicians Surg Pak. 2013;23(5):338-41.
13. Jenkinson MD, Hayhurst C, Al-Jumaily M, Kandasamy J, Clark S, Mallucci CL. The role of endoscopic third ventriculostomy in adult patients with hydrocephalus: Clinical article. J Neurosurg. 2009;110(5):861-6.
14. Gangemi M, Mascari C, Maiuri F, Godano U, Donati P, Longatti P. Long-term outcome of endoscopic third ventriculostomy in obstructive hydrocephalus. Minim Invasive Neurosurg. 2007;50(05):265-69.
15. Buxton N, Turner B, Ramli N, Vloeberghs M. Changes in third ventricular size with neuroendoscopic third ventriculostomy: a blinded study. J Neurol, Neurosurg & Psychiatry. 2002;72(3):385-7.
16. Warf BC, Campbell JW. Combined endoscopic third ventriculostomy and choroid plexus cauterization as primary treatment of hydrocephalus for infants with myelomeningocele: long-term results of a prospective intent-to-treat study in 115 East African infants: Clinical article. J Neurosurg: Pediatr. 2008;2(5):310-6.
17. Melot A, Curey-Lévêque S, Derrey S, Gérardin E, Borden A, Fréger P, et al. Endoscopic 3rd ventriculocisternostomy: Procedural complications and long-term dysfunctions? Neurochir. 2013;59(4):165-70.
18. Dandy WE. Extirpation of the choroid plexus of the lateral ventricles in communicating hydrocephalus. Annals Surg.1918;68(6):569.
19. Hopf NJ, Grunert P, Fries G, Resch K, Perneczky A. Endoscopic third ventriculostomy: outcome analysis of 100 consecutive procedures. Neurosurg. 1999 ;44(4):795-804.
20. Stachura K, Grzywna E, Kwinta BM, Moska?a MM. Endoscopic third ventriculostomy–effectiveness of the procedure for obstructive hydrocephalus with different etiology in adults. Videosurg Other Miniinvasive Tech. 2014;9:586-95.
21. Javadpour M, Mallucci C, Brodbelt A, Golash A, May P. The impact of endoscopic third ventriculostomy on the management of newly diagnosed hydrocephalus in infants. Pediatr Neurosurg.2001;35(3):131-5.
22. Gorayeb RP, Cavalheiro S, Zymberg ST. Endoscopic third ventriculostomy in children younger than 1 year of age. J Neurosurg: Pediatr.2004;100(5):427-9.
23. Choi JU, Kim DS, Kim SH. Endoscopic surgery for obstructive hydrocephalus. Yonsei Med J 1999;40(6):600-7.
24. Duru S, Peiro JL, Oria M, Aydin E, Subasi C, Tuncer C, et al. Successful endoscopic third ventriculostomy in children depends on age and etiology of hydrocephalus: outcome analysis in 51 pediatric patients. Child's Nerv Syst. 2018;34(8):1521-8.
25. Idowu O, Falope L, Idowu A. Outcome of endoscopic third ventriculostomy and Chhabra shunt system in noncommunicating non-tumor childhood hydrocephalus. J Pediatr Neurosci. 2009;4(2):66.
26. Tamburrini G, Pettorini B, Massimi L, Caldarelli M, Di Rocco C. Endoscopic third ventriculostomy: the best option in the treatment of persistent hydrocephalus after posterior cranial fossa tumour removal? Child Nerv Syst. 2008;24(12):1405.
27. Fritsch MJ, Doerner L, Kienke S, Mehdorn HM. Hydrocephalus in children with posterior fossa tumors: role of endoscopic third ventriculostomy. J Neurosurg: Pediatr.2005;103(1):40-2.
28. Klimo Jr P, Goumnerova LC. Endoscopic third ventriculocisternostomy for brainstem tumors. J Neurosurg: Pediatr. 2006;105(4):271-4.
29. Mohanty A, Biswas A, Satish S, Vollmer DG. Efficacy of endoscopic third ventriculostomy in fourth ventricular outlet obstruction. Neurosurg. 2008;63(5):905-14..
30. El-Ghandour NM. Endoscopic third ventriculostomy versus ventriculoperitoneal shunt in the treatment of obstructive hydrocephalus due to posterior fossa tumors in children. Child Nerv Syst. 2011;27(1):117-26.
31. Fritsch MJ, Kienke S, Ankermann T, Padoin M, Mehdorn HM. Endoscopic third ventriculostomy in infants. J Neurosurg: Pediatr. 2005;103(1):50-3.
32. Jones R, Stening W, Brydon M. Endoscopic third ventriculostomy. Neurosurg.1990;26(1):86-92.
Downloads
Published
Issue
Section
License
The work published by PJNS is licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). Copyrights on any open access article published by Pakistan Journal of Neurological Surgery are retained by the author(s).