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Published in: Child's Nervous System 5/2024

29-12-2023 | Hydrocephalus | Research

“Various factors affecting the success of the ETV procedure in infants”—an insight via a prospective study

Author: Rajat Verma

Published in: Child's Nervous System | Issue 5/2024

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Abstract

Background

Congenital hydrocephalus in infants treated with ETV has variable results in literature. We studied some supposed clinicoradiological parameters which though are considered vital in deciding operative management and have never been thoroughly studied to establish a well-defined association.

Aim and objective

To evaluate the influence of clinicoradiological profile and intraoperative findings over the outcome of ETV done in infants for congenital hydrocephalus.

Materials and methods

All infants who underwent ETV in King George’s Medical University, Lucknow, from January 2019 to February 2020 for congenital hydrocephalus were included. Their clinical, radiological, operative data was gathered. Infants were followed at 1, 3, and 6 months after ETV. ETV success was defined as stabilization of abnormal head growth with resolution of symptoms of raised ICP and no requirement of shunt surgery 6 months post-ETV. All the clinicoradiological and intraoperative factors were statistically correlated with the final outcome.

Results

Forty infants were operated for congenital hydrocephalus during the study period in our institution. Failure rate was higher in children younger than 3 months (p value of 0.04). Increase in head size was present in all 40 cases and bulging anterior fontanelle in 95% cases. Success rate of ETV at 1, 3, and 6 months was 62.5%, 40%, and 35%. Most of failure occurred within 3 months after the procedure. Expiry rate at 1, 3, and 6 month was 15%, 17.5%, and 17.5%. None of the intraoperative findings significantly correlated with the final outcome.

Conclusion

ETV can be a luring treatment of congenital hydrocephalus in infants but has limited success rate because of the dependency of procedure on well-formed arachnoid villi for absorption. It also carries minimal risk of fatal complications like CSF leak and meningitis associated with it. Age is the only factor which truly reflects the outcome of the procedure.
Literature
Metadata
Title
“Various factors affecting the success of the ETV procedure in infants”—an insight via a prospective study
Author
Rajat Verma
Publication date
29-12-2023
Publisher
Springer Berlin Heidelberg
Published in
Child's Nervous System / Issue 5/2024
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-023-06268-6

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