Endoscopic Third Ventriculostomy: The Lebanese Experience

Abstract

Background: Endoscopic third ventriculostomy (ETV) has gained wide popularity as a first-line treatment for obstructive hydrocephalus (OHC). We have been performing ETV since 1998. We report our experience with this technique in the management of OHC. Methods: Between 1998 and 2007, we performed 49 ETV procedures in 46 patients suffering from OHC. Medical records were retrospectively reviewed. Success was defined as shunt-free survival. Results: There were 29 males and 17 females with a mean age of 23 years (6 months–65 years). Aqueductal stenosis and tectal tumor were the most common etiologies (63%). Seven patients (15.6%) had early ETV failure. Of 38 patients with initial success and available follow-up, shunt independence was achieved in 29 patients (76.3%) after a mean follow-up of 37 months. Kaplan-Meier analysis yielded a 70% 5-year shunt-free survival rate. On multivariate analysis, no variables could predict early or late ETV failure. Transient complications occurred in 6 patients (13%), but there were no ETV-related deaths or permanent morbidity. Conclusion: ETV is a safe and effective treatment for OHC, resulting in a high rate of long-term shunt independence with a low risk of complications. ETV should be considered the treatment of choice for patients with OHC and its development as a substitute to shunt placement should be encouraged in neurosurgically developing countries.

The Success of Endoscopic Third Ventriculostomy in Children: Analysis of Prognostic Factors

“…The overall SR to restore CSF circulation was 80% and the absolute CR was 13%. These data are in accordance with those reported in the literature [28,29,30,31,32]. …”

“…Current experience throughout the world shows that this treatment is a good alternative to the use of shunts in many cases of brain disease, and particularly in obstructive hydrocephalus. ETV is considered to be a simple, fast and safe procedure in children [13,18,19,26,27,28]. …”

Endoscopic Third Ventriculostomy in 250 Adults With Hydrocephalus

“…populations [11][12][13][14][15] or combined pediatric and adult populations. [16][17][18][19][20][21] Studies evaluating the utility of ETV in the treatment of all causes of adult hydrocephalus are less frequent. 22,23 This report reviews the experience with 250 ETV procedures performed by a single neurosurgical service over a 14.5-year period for the management of a variety of conditions causing hydrocephalus in adults.…”

Efficacy of endoscopic third ventriculostomy in the management of hydrocephalus in children under 2 years of age: Experience from a tertiary institution in Nigeria

“…[14] Most studies both in developing and developed nations had reported an ETV success within the range of 70-80%. [15][16][17][18] The standard imaging modality for diagnosis and classification of hydrocephalus is a brain CT scan. Use of MRI does not add any advantage but rather more expensive.…”