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CC BY-NC-ND 4.0 · Asian J Neurosurg 2020; 15(02): 302-305
DOI: 10.4103/ajns.AJNS_17_20
Original Article

Endoscopic third ventriculostomy for hydrocephalus in infants: A single-center experience

Krishna Lodha
Department of Neurosurgery MB Hospital, RNT Medical College, Udaipur, Rajasthan
,
Gaurav Jaiswal
Department of Neurosurgery MB Hospital, RNT Medical College, Udaipur, Rajasthan
,
Tarun Gupta
Department of Neurosurgery MB Hospital, RNT Medical College, Udaipur, Rajasthan
,
Vibhushankar Parashar
Department of Neurosurgery MB Hospital, RNT Medical College, Udaipur, Rajasthan
,
Yogendra Singh
Department of Neurosurgery MB Hospital, RNT Medical College, Udaipur, Rajasthan
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Introduction: Hydrocephalus remains one of the more common pathologies managed in pediatric neurosurgery. Endoscopic third ventriculostomy (ETV) has become the procedure of choice for the treatment of hydrocephalus due to aqueductal stenosis with high success rate. It has an advantage over ventriculoperitoneal (VP) shunting, as it enables patients to remain device free. Objective: The purpose of this study is to assess the role of ETV in the treatment of hydrocephalus in children under 1 year of age, including preterm low birth weight infants. Materials and Methods: A prospective study of 30 infants undergoing ETV in our institution between January 2014 and December 2018 was carried out. There were 25 cases of congenital hydrocephalus with aqueductal stenosis, two cases of Dandy–Walker cyst, two cases of cerebellopontine angle arachnoid cyst, and one case of posttubercular meningitis. ETV success score was calculated preoperatively to evaluate the percentage of success of ETV. Results: The overall success rate was 76.66% (23), with highest success rate of 84% in aqueductal stenosis. The mean age was 6.75 months (range: 1.5–12 months). Five infants were born preterm, four of them required a permanent VP shunt. There were two cases of intraoperative bleeding, four cases of cerebrospinal fluid leak from the wound, and one case of meningitis. Conclusion: ETV can be considered a safe and effective modality for the initial treatment of hydrocephalus in full-term normal birth weight infants, while the success of ETV in preterm low birth weight infants need further study of maturity at birth and birth weight as the determinant factors for the success of ETV in this special group.

Key-words:

Endoscopic third ventriculostomy - hydrocephalus - infant

Financial support and sponsorship

Nil.




Publication History

Received: 15 January 2020

Accepted: 20 April 2020

Article published online:
16 August 2022

© 2020. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Elbaba S, Steinmetz M, Ross J, Moon D, Luciano M. Endoscopic third ventriculostomy for objective hydrocephalus in the pediatric population: Evaluation of outcome. Eur J Pediatr Surg 2001;11 Supp 1:S52-4.
  • 2 Saute JAM, Jardim LB. Riluzole in patients with hereditary cerebellar ataxia. Lancet Neurol 2016;15:788-9.
  • 3 Koch D, Wagner W. Endoscopic third ventriculostomy in infants of less than 1 year of age: Which factors influence the outcome? Childs Nerv Syst 2004;20:405-11.
  • 4 Gorayeb RP, Cavalheiro S, Zymberg ST. Endoscopic third ventriculostomy in children younger than 1 year of age. J Neurosurg 2004;100:427-9.
  • 5 Yadav YR, Jaiswal S, Adam N. Endoscopic third ventriculostomy in infants. Neurology (India) 2006;54:161-3.
  • 6 Etus V, Ceylan S. Success of endoscopic third ventriculostomy in children less than 2 years of age. Neurosurg Rev 2005;28:284-8.
  • 7 Kulkarni AV, Drake JM, Mallucci CL, Sgouros S, Roth J, Constantini S, et al. Endoscopic third ventriculostomy in the treatment of childhood hydrocephalus. J Pediatr 2009;155:254-90.
  • 8 Grunert P, Charalampaki P, Hopf N, Filippi R. The role of third ventriculostomy in the management of obstructive hydrocephalus. Minim Invasive Neurosurg 2003;46:16-21.
  • 9 Ogiwara H, Dipatri AJ Jr., Alden TD, Bowman RM, Tomita T. Endoscopic third ventriculostomy for obstructive hydrocephalus in children younger than 6 months of age. Childs Nerve Syst 2010;26:343-7.
  • 10 Jung TY, Chong S, Kim IY, Lee JY, Phi JH, Kim SK, et al. Prevention of complications in endoscopic third ventriculostomy. J Korean Neurosurg Soc 2017;60:282-8.
  • 11 Zucchelli M, Galassi E. Higher failure of endoscopic third ventriculostomy in infants: The “distensible” skull is the culprit. Pediatr Neurosurg 2018;53:163-6.
  • 12 Vulcu S, Eickele L, Cinalli G, Wagner W, Oertel J. Long-term results of endoscopic third ventriculostomy: An outcome analysis. J Neurosurg 2015;123:1456-62.
  • 13 Elgamal EA, El-Dawlatly AA, Murshid WR, El-Watidy SM, Jamjoom ZA. Endoscopic third ventriculostomy for hydrocephalus in children younger than 1 year of age. Childs Nerv Syst 2011;27:111-6.
  • 14 Furlanetti LL, Santos MV, Oliveira RS. Neuroendoscopic surgery in children: An analysis of 200 consecutive procedures. Arq Neuropsiquiatr 2013;71:165-70.
  • 15 Jernigan SC, Berry JG, Graham DA, Goumnerova L. The comparative effectiveness of ventricular shunt placement versus endoscopic third ventriculostomy for initial treatment of hydrocephalus in infants. J Neurosurg Pediatr 2014;13:295-300.