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CC BY-NC-ND 4.0 · Asian J Neurosurg 2019; 14(01): 35-40
DOI: 10.4103/ajns.AJNS_187_16
Original Article

Endoscopic third ventriculostomy in noncommunicating hydrocephalus: Report on a short series of 53 children

Authors

  • Arif Sarmast

    Department of Neurosurgery, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India

  • Nayil Khursheed

    Department of Neurosurgery, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India

  • Altaf Ramzan

    Department of Neurosurgery, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India

  • Feroz Shaheen

    1   Department of Radiodiagnosis, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India

  • Abrar Wani

    Department of Neurosurgery, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India

  • Sarbjit Singh

    Department of Neurosurgery, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India

  • Zulfikar Ali

    2   Department of Neuroanesthesiology, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India

  • Bashir Dar

    2   Department of Neuroanesthesiology, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
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Introduction: Endoscopoic third ventriculostomy (ETV) is currently considered the best alternative to cerebrospinal fluid (CSF) shunt systems in the treatment of obstructive hydrocephalus. The aim of ETV is to communicate the third ventricle with the interpendicular cistern and create CSF flow which bypasses an obstruction to the circulation of the CSF. Aims and Objectives: The purpose of this study was to elucidate the indications, efficacy, safety and outcome Of ETV pediatric patients of noncommunicating hydrocephalus. Material and Methods: This study is a 3 year prospective study from June 2012 to May 2015. Records were kept for age, gender, etilogical factors, symptoms, signs, previous use of shunt or external ventricular device, imaging findings, and surgical complications (intraoperative and postoperative). Only those patients with age between 6months and 18 years with symptoms of intracranial hypertension and radiographic evidence of noncommunicating hydrocephalus were included in the study. Results: A total of 53 patients were studied, out of these 29 were boys and 24 were girls. The mean age of the patients was 6.6 years. Overall a total of 50 successful ETVs were done in 53 patients. The success rate is estimated to be 94%. There was no mortality. The average postoperative hospital stay was 4 days. The followup ranged from 6 to 16 months (mean, 12 months). Conclusion: ETV in children is a safe, simple and effective treatment and a logical alternative to shunting procedure for patients of noncommunicating hydrocephalus.

Key-words:

Endoscopic third ventriculostomy - hydrocephalus - shunt failure

Financial support and sponsorship

Nil.




Publication History

Article published online:
09 September 2022

© 2019. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 Mixter WJ. Ventriculocopy and puncture of the floor of the third ventricle. Boston Med J 1923;188:277-8.
  • 2 Paulsen AH, Lundar T, Lindegaard KF. Twenty-year outcome in young adults with childhood hydrocephalus: Assessment of surgical outcome, work participation, and health-related quality of life. J Neurosurg Pediatr 2010;6:527-35.
  • 3 Feng H, Huang G, Liao X, Fu K, Tan H, Pu H, et al. Endoscopic third ventriculostomy in the management of obstructive hydrocephalus: An outcome analysis. J Neurosurg 2004;100:626-33.
  • 4 Reddy GK, Bollam P, Caldito G, Guthikonda B, Nanda A. Ventriculoperitoneal shunt surgery outcome in adult transition patients with pediatric-onset hydrocephalus. Neurosurgery 2012;70:380-8.
  • 5 Boschert J, Hellwig D, Krauss JK. Endoscopic third ventriculostomy for shunt dysfunction in occlusive hydrocephalus: Long-term follow up and review. J Neurosurg 2003;98:1032-9.
  • 6 Jaksche H, Loew F. Burr hole third ventriculo-cisternostomy. An unpopular but effective procedure for treatment of certain forms of occlusive hydrocephalus. Acta Neurochir (Wien) 1986;79:48-51.
  • 7 Jones RF, Stening WA, Brydon M. Endoscopic third ventriculostomy. Neurosurgery 1990;26:86-91.
  • 8 Buxton N, Macarthur D, Mallucci C, Punt J, Vloeberghs M. Neuroendoscopy in the premature population. Childs Nerv Syst 1998;14:649-52.
  • 9 Ambesh SP, Kumar R. Neuroendoscopic procedures: Anesthetic considerations for a growing trend: A review. J Neurosurg Anesthesiol 2000;12:262-70.
  • 10 de Resende MA, da Silva EV, Nascimento OJ, Gemal AE, Quintanilha G, Vasconcelos EM. Total intravenous anesthesia (TIVA) in an infant with Werdnig-Hoffmann disease. Case report. Rev Bras Anestesiol 2010;60:170-5.
  • 11 Beems T, Grotenhuis JA. Is the success rate of endoscopic third ventriculostomy age-dependent? An analysis of the results of endoscopic third ventriculostomy in young children. Childs Nerv Syst 2002;18:605-8.
  • 12 Etus V, Ceylan S. Success of endoscopic third ventriculostomy in children less than 2 years of age. Neurosurg Rev 2005;28:284-8.
  • 13 Javadpour M, Mallucci C, Brodbelt A, Golash A, May P. The impact of endoscopic third ventriculostomy on the management of newly diagnosed hydrocephalus in infants. Pediatr Neurosurg 2001;35:131-5.
  • 14 Balthasar AJ, Kort H, Cornips EM, Beuls EA, Weber JW, Vles JS. Analysis of the success and failure of endoscopic third ventriculostomy in infants less than 1 year of age. Childs Nerv Syst 2007;23:151-5.
  • 15 Cinalli G, Sainte-Rose C, Chumas P, Zerah M, Brunelle F, Lot G, et al. Failure of third ventriculostomy in the treatment of aqueductal stenosis in children. J Neurosurg 1999;90:448-54.
  • 16 Gorayeb RP, Cavalheiro S, Zymberg ST. Endoscopic third ventriculostomy in children younger than 1 year of age. J Neurosurg 2004;100 5 Suppl Pediatrics: 427-9.
  • 17 Leach P, Thorne J, Palmer J. Response to: Ten years of experience with paediatric neuroendoscopic third ventriculostomy features and perioperative complications of 210 cases. J Neurosurg Anesthesiol 2005;17:172.
  • 18 Mohanty A, Vasudev MK, Sampath S, Radhesh S, Sastry Kolluri VR. Failed endoscopic third ventriculostomy in children: Management options. Pediatr Neurosurg 2002;37:304-9.
  • 19 Woodworth G, McGirt MJ, Thomas G, Williams MA, Rigamonti D. Prior CSF shunting increases the risk of endoscopic third ventriculostomy failure in the treatment of obstructive hydrocephalus in adults. Neurol Res 2007;29:27-31.
  • 20 Baldauf J, Oertel J, Gaab MR, Schroeder HW. Endoscopic third ventriculostomy in children younger than 2 years of age. Childs Nerv Syst 2007;23:623-6.
  • 21 Koch D, Wagner W. Endoscopic third ventriculostomy in infants of less than 1 year of age: Which factors influence the outcome? Childs Nerv Syst 2004;20:405-11.
  • 22 Fritsch MJ, Kienke S, Ankermann T, Padoin M, Mehdorn HM. Endoscopic third ventriculostomy in infants. J Neurosurg 2005;103 1 Suppl: 50-3.
  • 23 Koch-Wiewrodt D, Wagner W. Success and failure of endoscopic third ventriculostomy in young infants: Are there different age distributions? Childs Nerv Syst 2006;22:1537-41.
  • 24 Kombogiorgas D, Sgouros S. Assessment of the influence of operative factors in the success of endoscopic third ventriculostomy in children. Childs Nerv Syst 2006;22:1256-62.
  • 25 Levy ML, Masri LS, McComb JG. Outcome for preterm infants with germinal matrix hemorrhage and progressive hydrocephalus. Neurosurgery 1997;41:1111-7.
  • 26 Hoffman HJ, Harwood-Nash D, Gilday DL. Percutaneous third ventriculostomy in the management of noncommunicating hydrocephalus. Neurosurgery 1980;7:313-21.
  • 27 Wachter D, Behm T, von Eckardstein K, Rohde V. Indocyanine green angiography in endoscopic third ventriculostomy. Neurosurgery 2013;73 1 Suppl Operative: ons67-72; ons72-3.
  • 28 Nowoslawska E, Polis L, Kaniewska D, Mikolajczyk W, Krawczyk J, Szymanski W, et al. Influence of neuroendoscopic third ventriculostomy on the size of ventricles in chronic hydrocephalus. J Child Neurol 2004;19:579-87.
  • 29 Baykan N, Isbir O, Gerçek A, Dagçnar A, Ozek MM. Ten years of experience with pediatric neuroendoscopic third ventriculostomy: Features and perioperative complications of 210 cases. J Neurosurg Anesthesiol 2005;17:33-7.
  • 30 Buxton N. Neuroendoscopic third ventriculostomy. Neurosurg Focus 1999;6:e2.
  • 31 Di Roio C, Mottolese C, Cayrel V, Berlier P, Artru F. Ventriculostomy of the third ventricle and diabetes insipidus. Ann Fr Anesth Reanim 1999;18:776-8.
  • 32 Grant JA, McLone DG. Third ventriculostomy: A review. Surg Neurol 1997;47:210-2.
  • 33 Enya S, Masuda Y, Terui K. Respiratory arrest after a ventriculoscopic surgery in infants: Two case reports. Masui 1997;46:416-20.
  • 34 Anandh B, Madhusudan Reddy KR, Mohanty A, Umamaheswara Rao GS, Chandramouli BA. Intraoperative bradycardia and postoperative hyperkalemia in patients undergoing endoscopic third ventriculostomy. Minim Invasive Neurosurg 2002;45:154-7.
  • 35 Abtin K, Thompson BG, Walker ML. Basilar artery perforation as a complication of endoscopic third ventriculostomy. Pediatr Neurosurg 1998;28:35-41.
  • 36 Horowitz M, Albright AL, Jungreis C, Levy EI, Stevenson K. Endovascular management of a basilar artery false aneurysm secondary to endoscopic third ventriculostomy: Case report. Neurosurgery 2001;49:1461-4.
  • 37 McLaughlin MR, Wahlig JB, Kaufmann AM, Albright AL. Traumatic basilar aneurysm after endoscopic third ventriculostomy: Case report. Neurosurgery 1997;41:1400-3.
  • 38 Schroeder HW, Warzok RW, Assaf JA, Gaab MR. Fatal subarachnoid hemorrhage after endoscopic third ventriculostomy. Case report. J Neurosurg 1999;90:153-5.
  • 39 Schmidt RH. Use of a microvascular Doppler probe to avoid basilar artery injury during endoscopic third ventriculostomy. Technical note. J Neurosurg 1999;90:156-9.
  • 40 Gangemi M, Donati P, Maiuri F, Longatti P, Godano U, Mascari C. Endoscopic third ventriculostomy for hydrocephalus. Minim Invasive Neurosurg 1999;42:128-32.
  • 41 Yadav YR, Jaiswal S, Adam N, Basoor A, Jain G. Endoscopic third ventriculostomy in infants. Neurol India 2006;54:161-3.
  • 42 Mayah KN. Endoscopic third ventriculostomy – Experience in Basrah. Iraq Pan Arab J Neurosurg 2009;13:43-8.
  • 43 Idowu OE, Falope LO, Idowu AT. Outcome of endoscopic third ventriculostomy and Chhabra shunt system in noncommunicating non-tumor childhood hydrocephalus. J Pediatr Neurosci 2009;4:66-9.