Child's Nervous System

, Volume 30, Issue 5, pp 859–866 | Cite as

ETV as a last resort

  • Tafadzwa Mandiwanza
  • Zaitun Zakaria
  • Ayman Khalil
  • Darach Crimmins
  • John Caird
Original Paper



The field of neuroendoscopy is rapidly expanding with increasing indications for endoscopic third ventriculostomy (ETV).


As a treatment for hydrocephalus, ETV has the advantage of providing a more physiological cerebrospinal fluid diversion without shunt hardware which reduces the risk of recurrent infection and malfunction. The success rate of ETV has been increasing with decreasing morbidity and mortality.


Originally, ETV was indicated for cases of obstructive hydrocephalus, however the indications are expanding. To highlight this, we present a small series of cases were ETV is not traditionally indicated and was a treatment of last choice.


Endoscopic third ventriculostomy Slit ventricle syndrome Spina bifida Hydrocephalus 



The first author is currently in receipt of an educational grant from DePuy Synthes.

Financial disclosures


Conflict of interest



  1. 1.
    Chernov M, Kamikawa S, Yamane F, Ishihara S, Hori T (2005) Neurofiberscope-guided management of slit-ventricle syndrome due to shunt placement. J Neurosurg Pediatr 102(suppl 3):260–267CrossRefGoogle Scholar
  2. 2.
    Drake J, Kestle J, Milner R, Cinalli G, Boop F, Piatt JJ, Haines S, Schiff S, Cochrane D, Steinbok P, MacNeil N (1998) Randomized trial of cerebrospinal fluid shunt valve design in pediatric hydrocephalus. Neurosugery 43(2):294–303CrossRefGoogle Scholar
  3. 3.
    Gallo P, Szathmari A, De Biasi S, Mottolese C (2010) Endoscopic third ventriculostomy in obstructive infantile hydrocephalus: remarks about the so-called “unsuccessful cases”. Pediatr Neurosurg 46(6):435–441PubMedCrossRefGoogle Scholar
  4. 4.
    Grant J (1996) Victor Darwin L’Espinasse: a biographical sketch. Neurosurgery 39(6):1232–1233PubMedCrossRefGoogle Scholar
  5. 5.
    Hailong F, Guangfu H, Haibin T, Hong P, Yong C, Weidong L, Dongdong Z (2008) Endoscopic third ventriculostomy in the management of communicating hydrocephalus: a preliminary study. J Neurosurg 109(5):923–930PubMedCrossRefGoogle Scholar
  6. 6.
    Hellwig D, Grotenhuis J, Tirakotai W, Riegel T, Schulte D, Bauer B, Bertalanffy H (2005) Endoscopic third ventriculostomy for obstructive hydrocephalus. Neurosurgery Review 28(1–34)Google Scholar
  7. 7.
    Kadrian D, van Gelder J, Florida D, Jones R, Vonau M, Teo C, Stening W, Kwok B (2005) Long-term reliability of endoscopic third ventriculostomy. Neurosugery 56(6):1271–1278CrossRefGoogle Scholar
  8. 8.
    Koch D, Wagner W (2004) Endoscopic third ventriculostomy in infants of less than 1 year of age: which factors influence the outcome. Childs Nerv Syst 20(6):405–411PubMedCrossRefGoogle Scholar
  9. 9.
    Koch-Wiewrodt D, Wagner W (2006) Success and failure of endoscopic third ventriculostomy in young infants: are there different age distributions. Childs Nerv Syst 22(12):1537–1541PubMedCrossRefGoogle Scholar
  10. 10.
    Li K, Roonprapunt C, Lawson H, Abbott I, Wisoff J, Epstein F, Jallo G (2005) Endoscopic third ventriculostomyfor hydrocephalus associated with tectal gliomas. Neurosurgery Focus 18(6A):E2Google Scholar
  11. 11.
    Neils D, Wang H, Lin J (2013) Endoscopic third ventriculostomy for shunt malfunction: what to do with the shunt? Surgical Neurology International. doi: 10.4103/2152-7806.106116 PubMedCentralPubMedGoogle Scholar
  12. 12.
    O’Brien D, Seghedoni A, Collins D, Hayhurst C, Mallucci C (2006) Is there an indication for ETV in young infants in aetiologies other than isolated aqueduct stenosis? Childs Nerv Syst 22:1565–1572. doi: 10.1007/s00381-006-0192-6 PubMedCrossRefGoogle Scholar
  13. 13.
    Oi S, Hidaka M, Honda Y, Togo K, Shinoda M, Shimoda M, Tsugane R, Sato O (1999) Neuroendoscopic surgery for specific forms of hydrocephalus. Childs Nerv Syst 15(56–68)Google Scholar
  14. 14.
    Pettorini B, Tamburrini G (2007) Two hundred years of endoscopic surgery: from Philipp Bozzini’s cystoscope to paediatric endoscopic neurosurgery. Childs Nerv Syst 23:723–724PubMedCrossRefGoogle Scholar
  15. 15.
    Sacko O, Boetto S, Lauwers-Cances V, Dupuy M, Roux F (2010) Endoscopic third ventriculostomy: outcome analysis in 368 procedures. J Neurosurg Pediatr 5(1):68–74PubMedCrossRefGoogle Scholar
  16. 16.
    Sainte-Rose C, Cinalli G, Roux F, Maixner R, Chumas P, Mansour M, Carpentier A, Bourgeois M, Zerah M, Pierre-Kahn A, Renier D (2001) Management of hydrocephalus in pediatric patients with posterior fossa tumors: the role of endoscopic third ventriculostomy. J Neurosurg 95(5):791–797PubMedCrossRefGoogle Scholar
  17. 17.
    Schmitt P, Jane JJ (2012) A lesson in history: the evolution of endoscopic third ventriculostomy. Neurosurg Focus 33(2):E11PubMedCrossRefGoogle Scholar
  18. 18.
    Shimizu T, Luciano M, Fukuhara T (2012) Role of endoscopic third ventriculostomy at infected cerebrospinal fluid shunt removal. J Neurosurg Pediatr 9(3):320–326PubMedCrossRefGoogle Scholar
  19. 19.
    Teo C, Jones R (1996) Management of hydrocephalus by endoscopic third ventriculostomy in patients with myelomeningocele. Pediatr Neurosurg 25(2):57–63PubMedCrossRefGoogle Scholar
  20. 20.
    Vogel T, Bahuleyan B, Robinson S, Cohen A (2013) The role of endoscopic third ventriculostomy in the treatment of hydrocephalus. J Neurosurg Pediatr 12(1):54–61PubMedCrossRefGoogle Scholar
  21. 21.
    Warf B, Mugamba J, Kulkarni A (2010) Endoscopic third ventriculostomy in the treatment of childhood hydrocephalus in Uganda: report of a scoring system that predicts success. J Neurosurg Pediatr 5(2):143–148PubMedCrossRefGoogle Scholar
  22. 22.
    Wu X, Luo C, Liu Z, Hu G, Chen J, Lu Y (2011) Complications following ventriculo-peritoneal and subsequent ventriculo-atrial shunting resolved by third ventriculostomy. Br J Neurosurg 25(2):300–302PubMedCrossRefGoogle Scholar
  23. 23.
    Yadav Y, Parihar V, Pande S, Namdev H, Agarwal M (2012) Endoscopic third ventriculostomy. J Neurosci in Rural Pract 3(2):163–173CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Tafadzwa Mandiwanza
    • 1
  • Zaitun Zakaria
    • 2
  • Ayman Khalil
    • 2
  • Darach Crimmins
    • 1
  • John Caird
    • 1
  1. 1.Pediatric NeurosurgeryChildren’s University HospitalDublin 1Ireland
  2. 2.Department of NeurosurgeryBeaumont HospitalDublin 9Ireland

Personalised recommendations