Clinical Outcomes of Endoscopic Third Ventriculostomy in Obstructive Hydrocephalus: A Single-Center Observational Study

Abstract

Introduction:  Endoscopic third ventriculostomy (ETV) is a well-established treatment for obstructive hydrocephalus and provides a more physiologic alternative to shunt surgery. But there is variability in clinical outcomes.

Objective:  To perform an exploratory analysis of factors associated with treatment success.

Methods:  We conducted a retrospective observational study of 36 patients who received ETV for obstructive hydrocephalus between February 2023 and December 2025. Patient characteristics, etiology, clinical presentation, and outcomes were reviewed. ETV was considered successful if there was clinical improvement without requiring further cerebrospinal fluid diversion. Chi-square and independent t-tests were used for statistical analysis.

Results:  The mean age range was 15 ± 10 years, and 66.7% were men. The most common diagnosis was aqueductal stenosis (50%). The success rate was 80.6% and the complication rate 13.9%. There was no significant correlation between success and age (p = 0.18), sex (p = 0.34), or etiology (p = 0.21), but a trend towards higher rates of success was observed in patients with aqueductal stenosis.

Conclusion:  ETV is a safe, successful method of treating obstructive hydrocephalus with good short-term results. Although no statistically significant associations were found, a trend towards superior outcome in certain etiologies was noted. Further research with larger cohorts and longer follow-up is needed to better characterize factors associated with the outcome.

Keywords:  ETV; obstructive hydrocephalus; aqueductal stenosis; CSF; neurosurgery; outcome