Long-Term Outcome of Endoscopic Third Ventriculostomy in Obstructive Hydrocephalus

M. Gangemi; C. Mascari; F. Maiuri; U. Godano; P. Donati; P. L. Longatti

doi:10.1055/s-2007-990305

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Minim Invasive Neurosurg 2007; 50(5): 265-269
DOI: 10.1055/s-2007-990305

Original Article

Long-Term Outcome of Endoscopic Third Ventriculostomy in Obstructive Hydrocephalus

M. Gangemi¹ , C. Mascari² , F. Maiuri¹ , U. Godano² , P. Donati⁴ , P. L. Longatti³

¹Department of Neurological Sciences, Neurosurgical Clinic, “Federico II” University, Naples, Italy
²Neurosurgical Department, Bellaria Hospital, Bologna, Italy
³Neurosurgical Department of Treviso Hospital, Treviso, Italy
⁴Division of Pediatric Neurosurgery, Mayer Children Hospital, Florence, Italy

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Publication History

Publication Date:
05 December 2007 (online)

Abstract
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Abstract

This multicentric study reports on 140 patients who underwent endoscopic third ventriculostomy for obstructive hydrocephalus in four Italian neurosurgical centers between 1994 and 1999. Its aim is to define the long-term outcome of these patients many years (6-12) after the initial procedure. The study includes both children and adults; the etiology of the hydrocephalus was malformative aqueductal stenosis in 88 cases (62.8%), compression by tumors of the mesencephalic and pineal regions and posterior fossa in 45 (32.2%) and post-infection aqueductal stenosis in 7 (5%). The ETV was performed by using the standard technique. The overall rate of good results (shunt-independent patients with clinical remission or improvement) was 87.1%. Eighteen patients (12.9%) required a shunt because of ETV failure. The long-term outcome of ETV in this study was not influenced by the patient's age and the etiology of the hydrocephalus (although cases secondary to cisternal hemorrhage and infections are not included). Other series including cases with long follow-up are analyzed. In conclusion, ETV results in a high rate of good long-term outcome in patients with obstructive hydrocephalus. Because postoperative failures occur early, clinical and radiological control studies must be performed particularly in the first years after the neuroendoscopic procedure.

Key words

hydrocephalus - endoscopic third ventriculostomy - aqueductal stenosis

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Correspondence

M. Gangemi

Divisione di Neurochirurgia

Ed. 16

Policlinico Universitario “Federico II”

V. Pansini 5

80131 Napoli

Italy

Phone: +39/081/7462 57 6

Fax: +39/081/7462 57 6

Email: mgangemi@unina.it