Endoscopic third ventriculostomy in children younger than 2 years of age

Baldauf, Jörg; Oertel, Joachim; Gaab, M. R.; Schroeder, Henry W. S.

doi:10.1007/s00381-007-0335-4

Cited by 125 publications

(78 citation statements)

References 25 publications

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“…In both congenital and acquired stenosis of the aqueduct, Jones et al [13,29] and, more recently, Mugamba and Stagno [13,29] reported high success rates that were related to the acquired type, the age at symptom onset and the surgical procedure [13,70,71]. Similarly, in our series, we found a success rate among adults of 87.5%, which is similar to that reported in more recent studies [13,56].…”

Section: Discussionsupporting

confidence: 91%

Endoscopic third ventriculostomy in the management of hydrocephalus: Outcome analysis of 168 consecutive procedures

Salvador

Oliveira

Pereira

et al. 2014

Clinical Neurology and Neurosurgery

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a b s t r a c tBackground: Endoscopic third ventriculostomy (ETV) is the treatment of choice for obstructive hydrocephalus, but the outcome is still controversial in terms of age and aetiology. Methods: Between 1998 and 2011, 168 consecutive procedures were performed in 164 patients, primarily children (56% < 18 years of age and 35% < 2 years of age). The causes of obstructive hydrocephalus included tumoural pathology, Chiari malformation, congenital obstruction of the aqueduct, post-infectious and post-haemorrhagic membranes, and ventriculo-peritoneal shunt (VPS) malfunctions. Successful ETV was defined by the resolution of symptoms and the avoidance of a shunt. Results: ETV was successful in 75.6% of patients, but 19% of the patients required VPS in the first month after ETV, and 5.4% required a VPS more than one month after ETV. Four patients were ultimately submitted for second ETVs. In this series, no major permanent morbidity or mortality was observed. Conclusions: ETV is a safe procedure and an effective treatment for obstructive hydrocephalus even following the dysfunction of previous VPSs and in children younger than two years.

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Section: Discussionsupporting

confidence: 91%

Endoscopic third ventriculostomy in the management of hydrocephalus: Outcome analysis of 168 consecutive procedures

Salvador

Oliveira

Pereira

et al. 2014

Clinical Neurology and Neurosurgery

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“…While some authors reported no correlation of hydrocephalus etiology with ETV outcomes, 3,8,19,21 others have found etiology to be predictive of ETV success. 1,9,10 Etiology of hydrocephalus accounts for up to 33% of the possible points in the aforementioned ETV success score paradigm. 10 A notable limitation of administrative databases, the MarketScan database included, is that ICD-9 coding with insurance claims may not be as reliable in classifying diagnoses as clinical studies.…”

Section: Discussionmentioning

confidence: 99%

“…25 Other smaller studies have reported conflicting information on the role of age, etiology, and other factors on the impact of success after ETV. 1,8,9,15,19 Kulkarni et al described multinational series; predictive strategies have been used to create success scores for various populations. 10,11,25 However, it remains to be seen if a national sample has similar ETV success compared with these site-specific studies.…”

mentioning

confidence: 99%

Pediatric endoscopic third ventriculostomy: a population-based study

Lam

Harris

Rocque

et al. 2014

PED

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Object Endoscopic third ventriculostomy (ETV) is an alternative to ventriculoperitoneal shunting for hydrocephalus treatment. Choice of treatment options raises questions about which patients are likely to benefit from ETV. The authors performed a population-based analysis using an administrative claims database, examining current practice and outcomes for pediatric patients in the US. Methods The authors queried the MarketScan (Truven Health Analytics) database for Current Procedural Terminology codes corresponding to ETV and ventriculoperitoneal shunting from 2003 to 2011; they included patients 19 years or younger and extracted data from initial and subsequent hospitalizations. Hydrocephalus etiology was classified with ICD-9-CM coding. ETV failure was defined as any subsequent ETV or shunt procedure. Results Five hundred one patients underwent ETV. Of these, 46% were female. The mean age was 8.7 ± 6.4 years (± SD). The mean follow-up was 1.9 ± 1.8 years. Etiology of hydrocephalus was primarily tumor (41.7%) and congenital/aqueductal stenosis (24.4%). ETV was successful in 354 patients (71%). The mean time to failure was 109.9 ± 233 days. Of the 147 patients with ETV failure, 35 (24%) underwent repeat ETV and 112 (76%) had shunt placement. Patients in age groups 0 to < 6 months and 6 months to < 1 year had a significantly higher rate of ETV failure than those 10–19 years (HR 2.9, p = 0.05; and HR 2.3, p = 0.001, respectively). History of prior shunt was associated with higher risk of failure (HR 2.5, p < 0.001). There were no significant associations between hydrocephalus etiology and risk of failure. A second wave of failures occurred at 2.5–3.5 years postoperative in tumor and congenital/aqueductal stenosis patients; this was not observed in other etiology groups. Conclusions This study represents a cross-section of nationwide ETV practice over 9 years. ETV success was more likely among children 1 year and older and those with no history of prior shunt.

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“…Reports have indicated that outcome is a function of age 23,32,33 independent of age, 1,34 a function of etiology, 1,35-37 or a function of both age and etiology. 38 More recent evidence from larger, and in one case, multicenter series has supported the finding that age is the main determinant of outcome with younger children, particularly neonates, faring worse. 39,40 The other standard technique of CSF diversion, a CSF shunt, has rarely been compared with ETV, with results suggesting no difference 41 or a slight advantage in terms of costeffectiveness for ETV.…”

Section: Discussionmentioning

confidence: 87%

Result of Endoscopic Third Ventriculostomy for Hydrocephalus Caused by Cerebral Aqueductal Stenosis in Infant Patients

Chowdhury

Haque

Kawsar

et al. 2017

IJNS

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Background Endoscopic third ventriculostomy (ETV) is one of the important management options for hydrocephalus, especially obstructive hydrocephalus. The result of ETV in different age and etiology is quite variable according to the different authors. The study was carried out to assess the success rate of ETV as a treatment for this type of hydrocephalus in infant age group. Material and Methods The study was done prospectively on infants (age 12 months) admitted in the period from January 2009 to June 2013 suffering from obstructive hydrocephalus due to cerebral aqueductal stenosis (CAS). After making the diagnosis, we counseled the patient party about the probability of high failure rate of ETV in this age group and probable necessity of a second operation. With the informed consent, we performed ETV in these cases and followed up regularly in postoperative period. Control neuroimaging studies were done whenever needed (suspected failure of ETV and suspected stomal block). Results Total 17 infants were studied. Average follow-up was 18.7 months. Twelve infants were between the age group of six and under six months while five were above six months to one year old. Fourteen (82.35%) out of 17 patients showed overall clinical improvement. Clinical improvement was seen in two (66.6%) infants aged 2 months or younger, three (75%) aged 2 þ to 3 months, five (100%) aged 3 þ to 6 months, and four (80%) aged 6 þ months to 1 year. Two patients had bleeding during surgery. Three developed CSF leak through the burr hole. In one case (the patient's age was 2 months), the stoma was found blocked, and hydrocephalus returned 9 weeks after ETV. In two patients, in whom VP shunt was needed, "failed ETV" was obvious in early postoperative period. In this series, average ETV success score (ETVSS) was 52.35 (range: 40-70) and overall success rate was 82.35%. This indicates that ETVSS does not correlate with the outcome of ETV in infants with CAS. Conclusion Outcome of ETV for hydrocephalus from CAS in infant is quite good and ETVSS does not correlate with the outcome.

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Endoscopic third ventriculostomy in children younger than 2 years of age

Cited by 125 publications

References 25 publications

Endoscopic third ventriculostomy in the management of hydrocephalus: Outcome analysis of 168 consecutive procedures

Endoscopic third ventriculostomy in the management of hydrocephalus: Outcome analysis of 168 consecutive procedures

Pediatric endoscopic third ventriculostomy: a population-based study

Result of Endoscopic Third Ventriculostomy for Hydrocephalus Caused by Cerebral Aqueductal Stenosis in Infant Patients

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