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Child's Nervous System
Published in: Child's Nervous System 8/2018

01-08-2018 | Original Paper

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

Authors: Soner Duru, Jose L Peiro, Marc Oria, Emrah Aydin, Canan Subasi, Cengiz Tuncer, Harold L Rekate

Published in: Child's Nervous System | Issue 8/2018

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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.
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Metadata
Title
Successful endoscopic third ventriculostomy in children depends on age and etiology of hydrocephalus: outcome analysis in 51 pediatric patients
Authors
Soner Duru
Jose L Peiro
Marc Oria
Emrah Aydin
Canan Subasi
Cengiz Tuncer
Harold L Rekate
Publication date
01-08-2018
Publisher
Springer Berlin Heidelberg
Published in
Child's Nervous System / Issue 8/2018
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-018-3811-0

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