Endoscopic Third Ventriculostomy: Outcome Analysis of 100 Consecutive Procedures

Hopf, Nikolai J.; Grunert, Peter; Fries, Georg; Resch, K. D. M.; Perneczky, Axel

doi:10.1097/00006123-199904000-00062

Cited by 433 publications

(288 citation statements)

References 32 publications

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“…ETV has been reported to be effective in the treatment of hydrocephalus with success rates ranging between 49 and 100%, depending on the aetiology of hydrocephalus, the criteria used for patient selection, and the follow-up period [2, 3, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15]. Despite these encouraging reports, most authors have suggested that the outcome following ETV is significantly worse in children less than 1 year old as compared with older children [4, 10, 16, 17, 18, 19].…”

Section: Discussionmentioning

confidence: 99%

“…Initially reported to work best in patients with late-onset aqueduct stenosis (AS), endoscopic third ventriculostomy (ETV) is now used in many centres for a wider variety of indications with varying success rates, depending on the aetiology of the hydrocephalus and the patient’s age [1, 2, 3, 4]. Despite the excellent results achieved in adults and older children, the reported outcome of ETV in children less than 1 year old has been disappointing, with success rates ranging between 0 and 23% [2, 5]. The aims of this study were to evaluate the role of ETV as a primary treatment for hydrocephalus in infants and to determine its impact as a whole on the reduction of cerebrospinal fluid (CSF) shunts necessary in a new population of hydrocephalic infants.…”

Section: Introductionmentioning

confidence: 99%

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The Impact of Endoscopic Third Ventriculostomy on the Management of Newly Diagnosed Hydrocephalus in Infants

et al. 2001

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Objectives: To evaluate the role of endoscopic third ventriculostomy (ETV) as a primary treatment for hydrocephalus in children less than 1 year old and to determine its impact as a whole on the reduction of shunts necessary in a new population of hydrocephalic infants. Methods: Data were collected prospectively on 47 infants with newly diagnosed hydrocephalus of all aetiologies who were referred between 1st April 1998 and 30th September 2000. Twenty-one patients (median age 6 weeks, range 34 weeks of gestation to 10 months) underwent ETV, while the remaining 26 patients had insertion of a ventriculoperitoneal shunt. Anatomical criteria and demonstration of third ventricle outflow obstruction on preoperative magnetic resonance imaging were used to select patients for ETV. Results: There was no mortality or major morbidity following ETV. The median follow-up period was 18 (range 8–36) months. During the follow-up period, the ETV remained patent in 7 (33%) of the 21 patients. Of the 14 patients with failed ETV, 11 had insertion of a ventriculoperitoneal shunt, while 3 have undergone successful redo ETV. Therefore, in total 10 patients (48%) of the ETV group remain shunt independent. The best results were obtained in patients with congenital aqueduct stenosis with 71% (5 of 7 patients) success rate, while patients with posthaemorrhagic hydrocephalus did particularly badly with only 1 of 10 patients having a successful ETV. Overall, 10 of 47 (21%) infants with newly diagnosed hydrocephalus have avoided a shunt. Conclusions: Our results suggest that the selective use of ETV as the primary treatment in infants with hydrocephalus is safe and can lead to a reduction in the shunted population of all newly diagnosed hydrocephalic infants by up to 21%. Success of ETV is aetiology, not age dependent.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Impact of Endoscopic Third Ventriculostomy on the Management of Newly Diagnosed Hydrocephalus in Infants

et al. 2001

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“…Cerebrospinal fluid (CSF) flow restoration is done by a variety of endoscopic techniques including ETV, aqueductoplasty, aqueduct stenting, septostomy, Monroplasty, and removal/decompression of CSF flow-obstructing mass lesions [3]. Basically, the technique of ETV involves telescope insertion through the lateral ventricle, into the third ventricle and perforating the third ventricular floor over the premamillary region by various techniques [4]. …”

Section: Introductionmentioning

confidence: 99%

Endoscopic Third Ventriculostomy through the Interfornicial Space

Husain

Rastogi²,

Jha³

2005

Pediatr Neurosurg

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Endoscopic third ventriculostomy (ETV) is the most common cranial endoscopic surgery being done worldwide for a variety of conditions resulting in hydrocephalus. We report ETV in a case of congenital hydrocephalus with deficient third ventricular roof and wide interfornicial space.A 6-month-old male child presented with gradual progressive head enlargement and signs of raised intracranial pressure. Computed tomography of the head showed aqueductal stenosis with enlargement of third and lateral ventricles. The patient was operated under general anesthesia with endotracheal intubation. A right coronal burr hole and free-hand entry were made into the right lateral ventricle. The anterior part of the septum and the third ventricular roof were deficient with a narrow Monro’s foramen and the third ventricular floor was visible through the space between both fornices. ETV was done in standard fashion. Postoperatively the patient showed uneventful recovery clinicoradiologically. We review the literature and discuss the findings and technique of ETV in this rare entity.

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“…The refinement of endoscopic techniques has given rise to widespread enthusiasm for endoscopy, and the great majority of neurosurgeons has accepted neuroendoscopy as a neurosurgical procedure for a wide range of ventricular diseases [1, 2, 3, 4, 5], as all previous reports have emphasized the speed, safety and simplicity of this procedure [2, 4]. Nevertheless, even in very experienced hands, some complications have been reported [1, 2, 3, 5].…”

Section: Introductionmentioning

confidence: 99%

“…Nevertheless, even in very experienced hands, some complications have been reported [1, 2, 3, 5]. The complication rate associated with endoscopic techniques is low however and varies from 4.1 to 20% [1, 5, 6].…”

Section: Introductionmentioning

confidence: 99%

Epidural Hematoma as a Complication of Endoscopic Biopsy and Shunt Placement in a Patient Harboring a Third Ventricle Tumor

Hamlat¹,

Heckly

Doumbouya

et al. 2004

Pediatr Neurosurg

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Although some complications have been reported when using endoscopic techniques, epidural hematoma (EDH) has rarely been caused. The authors report a case of EDH complicating a concomitant endoscopic biopsy procedure with ventricular shunt placement in a young, 14-year-old boy harboring a third ventricle tumor with a hydrocephalus. Few cases have been reported; however, the authors warn that there is a risk that EDH may develop following an endoscopic procedure and shunt placement.

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Endoscopic Third Ventriculostomy: Outcome Analysis of 100 Consecutive Procedures

Cited by 433 publications

References 32 publications

The Impact of Endoscopic Third Ventriculostomy on the Management of Newly Diagnosed Hydrocephalus in Infants

The Impact of Endoscopic Third Ventriculostomy on the Management of Newly Diagnosed Hydrocephalus in Infants

Endoscopic Third Ventriculostomy through the Interfornicial Space

Epidural Hematoma as a Complication of Endoscopic Biopsy and Shunt Placement in a Patient Harboring a Third Ventricle Tumor

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