Context: Endoscopic third ventriculostomy (ETV) is an accepted procedure for the treatment
of obstructive hydrocephalus. The role of endoscopic treatment in the management of
shunt malfunction was not extensively evaluated. The aim of this study is to evaluate
the success rate of ETV in pediatric patients formerly treated by ventriculoperitoneal
(V-P) shunt implantation. Materials and Methods: Thirty-three patients with their first shunt failure and obstructive hydrocephalus
in brain imaging between 2008 and 2014 were enrolled in this study. Results: The most common causes of hydrocephalus in these patients were aqueductal stenosis
and myelomeningocele with or without associated shunt infection. Of these 33 cases,
20 ETV procedures were successful, and 13 cases needed shunt revision after ETV failure.
There was no serious complication during ETV procedures. The follow-up period of patients
with successful ETV was 6–50 months (mean 18 months). The time interval between ETV
and new shunting subsequent to ETV failure was 24.4 days (10–95). Conclusions: ETV can be considered as an alternative treatment paradigm in patients with previous
shunt or new shunt failure with an acceptable success rate of 6o%, although long-term
follow-up is needed for these patients.
Key-words:
Endoscopic third ventriculostomy - revision - shunt
