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Repeat endoscopic third ventriculostomy success rate according to ventriculostoma closure patterns in children

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Abstract

Purpose

This study aimed to examine the success rate of repeat endoscopic third ventriculostomy (redo-ETV) according to pattern of ventriculostoma closure based on observations in 97 paediatric redo-ETV patients.

Methods

Clinical data and intraoperative video recordings of 97 paediatric hydrocephalus patients who underwent redo-ETV due to ventriculostoma closure at two institutions were retrospectively analysed. We excluded patients with a history of intraventricular haemorrhage, cerebrospinal fluid (CSF) infection or CSF shunt surgery and those with incompletely penetrated membranes during the initial ETV.

Results

Verification of ventriculostoma closure was confirmed with cine phase-contrast magnetic resonance imaging and classified into 3 types: type 1, total closure of the ventriculostoma by gliosis or scar tissue that results in a non-translucent/opaque third ventricle floor; type 2, narrowing/closure of the ventriculostoma by newly formed translucent/semi-transparent membranes; and type 3, presence of a patent ventriculostoma orifice with CSF flow blockage by newly formed reactive membranes or arachnoidal webs in the basal cisterns. The overall success rate of redo-ETV was 37.1%. The success rates of redo-ETV according to closure type were 25% for type 1, 43.6% for type 2 and 38.2% for type 3. The frequency of type 1 ventriculostoma closure was significantly higher in patients with myelomeningocele-related hydrocephalus.

Conclusion

For patients with ventriculostoma closure after ETV, reopening of the stoma can be performed. Our findings regarding the frequencies of ventriculostoma closure types and the success rate of redo-ETV in paediatric patients according to ventriculostoma closure type are preliminary and should be verified by future studies.

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References

  1. Anik I, Etus V, Anik Y, Ceylan S (2010) Role of interpeduncular and prepontine cistern cerebrospinal fluid flow measurements in prediction of endoscopic third ventriculostomy success in pediatric triventricular hydrocephalus. Pediatr Neurosurg 46:344–350

    Article  Google Scholar 

  2. Cinalli G, Sainte-Rose C, Chumas P, Zerah M, Brunelle F, Lot G, Pierre-Kahn A, Reiner D (1999) Failure of third ventriculostomy in the treatment of aqueductal stenosis in children. J Neurosurg 90:448–454

    Article  CAS  Google Scholar 

  3. Di Rocco C, Cinalli G, Massimi L, Spennato P, Cianciulli E, Tamburrini G (2006) Endoscopic third venrticulostomy in the treatment of hydrocephalus in pediatric patients. Adv Tech Stand Neurosurg 31:119–219

    Article  Google Scholar 

  4. Dusick JR, McArthur DL, Bergsneider M (2008) Success and complication rates of endoscopic third ventriculostomy for adult hydrocephalus: a series of 108 patients. Surg Neurology 69:5–15

    Article  Google Scholar 

  5. Etus V, Ceylan S (2005) Success of endoscopic third ventriculostomy in children less than 2 years of age. Neurosurg Rev 28:284–288

    Article  Google Scholar 

  6. Fukuhara T, Luciano MG, Kowalski RJ (2002) Clinical features of third ventriculostomy failures classified by fenestration patency. Surg Neurology 58:102–110

    Article  Google Scholar 

  7. 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 46:435–441

    Article  Google Scholar 

  8. Gianaris TJ, Nazar R, Middlebrook, Gonda DD, Jea A, Fulkerson DH (2017) Failure of ETV in patients with the highest ETV success scores. J Neurosurg Pediatr 20:225–231

    Article  Google Scholar 

  9. Hayashi N, Hamada H, Hirashima Y, Kuritomo M, Takaku A, Endo S (2000) Clinical features in patients requiring reoperation after failed endoscopic procedures for hydrocephalus. Minim ınvas Neurosurg 43:181–186

    Article  CAS  Google Scholar 

  10. He Z, An C, Zhang X, He X, Qiang L (2015) The efficacy analysis of endoscopic third ventriculostomy in infantile hydrocephalus. J Korean Neurosurg Soc 57:119–122

    Article  CAS  Google Scholar 

  11. Koch-Wiewrodt D, Wagner W (2006) Success and failure of endoscopic third ventriculostomy in young infants: are there different age distributions? Childs Nervous Syst 22:1537–1541

    Article  Google Scholar 

  12. Kulkarni AV, Sgouros S, Constantini S (2017) Outcome of treatment after failed endoscopic third ventriculostomy (ETV) in infants with aqueductal stenosis: results from the International Infant Hydrocephalus Study (IIHS). Childs Nerv System 33:747–752

    Article  Google Scholar 

  13. Mahapatra A, Mehr S, Singh D, Tandon M, Ganjoo P, Singh H (2011) Ostomy closure and the role of repeat endoscopic third ventriculostomy (re-ETV) in failed ETV procedures. Neurol India 59:867–873

    Article  Google Scholar 

  14. Marano PJ, Stone SSD, Mugamba J, Ssenyonga P, Warf EB, Warf BC (2015) Reopening of an obstructed third ventriculostomy: long-term success and factors affecting outcome in infants. J Neurosurg Pediatr 15:399–405

    Article  Google Scholar 

  15. Mohanty A, Vasudev MK, Sampath S, Radhesh, Kolluri VRS (2002) Failed endoscopic third ventriculostomy in children: management options. Pediatr Neurosurg 37:304–309

    Article  Google Scholar 

  16. Moreira I, Pereira J, Oliveira J, Salvador SF, Vaz R (2016) Endoscopic re-opening of third ventriculostomy: case series and review of literature. Clin Neurol Neurosurg 145:58–63

    Article  Google Scholar 

  17. Oertel J, Vulcu S, Eickele L, Wagner W, Cinalli G, Rediker J (2017) Long-term follow-up of repeat endoscopic third ventriculostomy in obstructive hydrocephalus. World Neurosurg 99:556–565

    Article  Google Scholar 

  18. Peretta P, Cinalli G, Spennato P, Ragazzi P, Ruggerio C, Aliberti F, Carlino C, Cianciulli E (2009) Long-term results of a second endoscopic third ventriculostomy in children: retrospective analysis of 40 cases. Neurosurg 65:539–547

    Article  Google Scholar 

  19. Siomin V, Weiner H, Wisoff J, Cinalli G, Pierre-Kahn A, Saint-Rose C, Abbott R, Elran H, Beni-Adani L, Ouaknine G, Constantini S (2001) Repeat endoscopic third ventriculostomy: is it worth trying? Childs Nerv Syst 17:551–555

    Article  CAS  Google Scholar 

  20. Surash S, Chumas P, Bhargava D, Crimmins D, Straiton J, Tyagi A (2010) A retrospective analysis of revision endoscopic third ventriculostomy. Childs Nervous Syst 26:1693–1698

    Article  Google Scholar 

  21. Tamburrini G, Frassinato P, Bianchi F, Massimi L, Di Rocco C, Caldarelli M (2015) Closure of endoscopic third ventriculostomy after surgery for posterior cranial fossa tumor: the ‘snow globe effect’. Br J Neurosurg 29:386–389

    Article  Google Scholar 

  22. Udayakumaran S, Joseph T (2019) Can we predict early endoscopic third ventriculostomy failure? The role of ultra-early postoperative magnetic resonance imaging in predicting early endoscopic third ventriculostomy failure. World Neurosurg 100013. https://doi.org/10.1016/j.wmsx.2019.100013

  23. Vulcu S, Eickele L, Cinalli G, Wagner W, Oertel J (2015) Long-term results of endoscopic third ventriculostomy: an outcome analysis. J Neurosurg 123:1456–1462

    Article  Google Scholar 

  24. Wagner W, Koch D (2005) Mechanisms of failure after endoscopic third ventriculostomy in young infants. J Neurosurg 103:43–49

    PubMed  Google Scholar 

  25. Warf BC, Bhai S, Kulkarni AV, Mugamba J (2012) Shunt survival after failed endoscopic treatment of hydrocephalus. J Neurosurg Pediatr 10:463–470

    Article  Google Scholar 

  26. Yadav YR, Mukerji G, Parihar V, Sinha M, Pandey S (2009) Complex hydrocephalus (combination of communicating and obstructive type): an important cause of failed endoscopic third ventriculostomy. BMC Res Notes 16:137

    Article  Google Scholar 

  27. Zucchelli M, Galassi E (2018) Higher failure of endoscopic third ventriculostomy in infants: the ‘distensible’ skull is the culprit. Pediatr Neurosurg 53:163–166

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Neurosurgery, Kocaeli University, Kocaeli, Turkey

    Volkan Etus & Hamza Genc

  2. Department of Neurosurgery, Ankara University, Sihhiye, 06100, Ankara, Turkey

    Gokmen Kahilogullari, Onur Ozgural & Agahan Unlu

  3. Department of Neurosurgery, Derince Training Hospital, Kocaeli, Turkey

    Aykut Gokbel

  4. Department of Neurosurgery, Karabuk University, Karabuk, Turkey

    Tugba Morali Guler

Authors
  1. Volkan Etus
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  2. Gokmen Kahilogullari
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  3. Aykut Gokbel
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  4. Hamza Genc
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  5. Tugba Morali Guler
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  6. Onur Ozgural
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  7. Agahan Unlu
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Correspondence to Gokmen Kahilogullari.

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Etus, V., Kahilogullari, G., Gokbel, A. et al. Repeat endoscopic third ventriculostomy success rate according to ventriculostoma closure patterns in children. Childs Nerv Syst 37, 913–917 (2021). https://doi.org/10.1007/s00381-020-04949-0

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  • DOI: https://doi.org/10.1007/s00381-020-04949-0

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