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Child's Nervous System

, Volume 34, Issue 8, pp 1521–1528 | Cite as

Successful endoscopic third ventriculostomy in children depends on age and etiology of hydrocephalus: outcome analysis in 51 pediatric patients

  • Soner Duru
  • Jose L Peiro
  • Marc Oria
  • Emrah Aydin
  • Canan Subasi
  • Cengiz Tuncer
  • Harold L Rekate
Original Paper

Abstract

Purpose

Endoscopic third ventriculostomy (ETV) has become the method of choice in the treatment of hydrocephalus. Age and etiology could determine success rates (SR) of ETV. The purpose of this study is to assess these factors in pediatric population.

Methods

Retrospective study on 51 children with obstructive hydrocephalus that underwent ETV was performed. The patients were divided into three groups per their age at the time of the treatment: < 6, 6–24, and > 24 months of age. All ETV procedures were performed by the same neurosurgeon.

Results

Overall SR of ETV was 80% (40/51) for all etiologies and ages. In patients < 6 months of age SR was 56.2% (9/16), while 6–24 months of age was 88.9% (16/18) and > 24 months was 94.1% (16/17) (p = 0.012). The highest SR was obtained on aqueductal stenosis. SR of posthemorrhagic, postinfectious, and spina bifida related hydrocephalus was 60% (3/5), 50% (1/2), and 14.3% (1/7), respectively. While SR rate at the first ETV attempt was 85.3%, it was 76.9% in patients with V-P shunt performed previously (p = 0.000).

Conclusions

Factors indicating a potential failure of ETV were young age and etiology such as spina bifida, other than isolated aqueductal stenosis. ETV is the method of choice even in patients with former shunting. Fast healing, distensible skulls, and lower pressure gradient in younger children, all can play a role in ETV failure. Based on our experience, ETV could be the first method of choice for hydrocephalus even in children younger than 6 months of age.

Keywords

Neuroendoscopy Aqueductal stenosis Infant Outcome 

Notes

Compliance with ethical standards

Conflict of interest

The author declares that author has no conflict of interest.

Ethical approval

Duzce University Clinical Researches Ethics Committee has approved this respective study (date: 2017, number 117). This study has been accepted as an e-poster presentation for ESPN biennial congress, 6–9 May 2018, in Bonn, Germany.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of NeurosurgeryDuzce University Faculty of MedicineDuzceTurkey
  2. 2.Fetal Center, Division of General and Thoracic SurgeryMLC 11020, Cincinnati Children’s Hospital and Medical CenterCincinnatiUSA
  3. 3.Long Island Jewish Medical CenterNorth Shore University Hospital, The Chiari InstituteManhassetUSA

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