Success Rate of Endoscopic Third Ventriculostomy (ETV) in Non-Communicating Hydrocephalus in Pediatric Age Group

Authors

  • Sanaullah Pathan Liaquat University Hospital, Hyderabad https://orcid.org/0000-0002-9740-089X
  • Riaz Ahmed Raja Memon Liaquat University of Medical and Health Sciences, Jamshoro
  • Peer Asad Aziz Qureshi Liaquat University Hospital, Hyderabad
  • Suhail Ahmed Aghani Liaquat University Hospital, Hyderabad
  • Abdul Rauf Memon Liaquat University of Medical and Health Sciences, Jamshoro
  • Mubarak Hussain Liaquat University of Medical and Health Sciences, Jamshoro

DOI:

https://doi.org/10.36552/pjns.v25i2.544

Keywords:

Endoscopic Third Ventriculostomy, Non-Communicating Hydrocephalus, Pediatric age groups, Cerebrospinal Fluid

Abstract

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.

Author Biographies

Sanaullah Pathan, Liaquat University Hospital, Hyderabad

Consultant Neurosurgeon, Department of Neurosurgery,Liaquat University Hospital, Hyderabad.

Riaz Ahmed Raja Memon, Liaquat University of Medical and Health Sciences, Jamshoro

Professor and Chairman, Department of Neurosurgery, Liaquat University of Medical and Health Sciences (LUMHS) , Jamshoro

Peer Asad Aziz Qureshi, Liaquat University Hospital, Hyderabad

Consultant Neurosurgeon, Department of Neurosurgery, Liaquat University Hospital, Hyderabad.

Suhail Ahmed Aghani, Liaquat University Hospital, Hyderabad

Cosnultant Neurosurgeon,Liaquat University Hospital, Hyderabad.

Abdul Rauf Memon, Liaquat University of Medical and Health Sciences, Jamshoro

Assistant professor, Department of Neurosurgery,Liaquat University of Medical and Health Sciences, Jamshoro

Mubarak Hussain, Liaquat University of Medical and Health Sciences, Jamshoro

Assistant Professor, Department of Neurosurgery, Liaquat University of Medical and Health Sciences, Jamshoro

References

1. Oreškovi? D, Radoš M, Klarica M. New Concepts of Cerebrospinal Fluid Physiology and Development of Hydrocephalus. Pediatr Neurosurg. 2017;52(6):417-425.
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

2021-06-14

Issue

Section

Original Articles