Higher Failure of Endoscopic Third Ventriculostomy in Infants: The “Distensible” Skull Is the Culprit

Zucchelli, Mino; Galassi, Ercole

doi:10.1159/000487090

Cited by 5 publications

(1 citation statement)

References 13 publications

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“…[9,10] Reasons for the low efficacy of ETV in preterm low birth weight infants are still debatable but distensible head with its immature skull may be real culprit, which would prevent an adequate flow through the ETV, and it may be responsible for insufficient pressure gradient between the cortical subarachnoid spaces and the venous sinuses as advised by Zucchelli and Galassi. [11] In the present study, the overall complication rate was 23.33%. The most common complications included CSF leak (13.33%), intraoperative bleeding (6.66%), and infection (3.33%) results were comparable to other studies.…”

Section: Discussionsupporting

confidence: 42%

Endoscopic third ventriculostomy for hydrocephalus in infants: A single-center experience

et al. 2020

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Introduction: Hydrocephalus remains one of the more common pathologies managed in pediatric neurosurgery. Endoscopic third ventriculostomy (ETV) has become the procedure of choice for the treatment of hydrocephalus due to aqueductal stenosis with high success rate. It has an advantage over ventriculoperitoneal (VP) shunting, as it enables patients to remain device free. Objective: The purpose of this study is to assess the role of ETV in the treatment of hydrocephalus in children under 1 year of age, including preterm low birth weight infants. Materials and Methods: A prospective study of 30 infants undergoing ETV in our institution between January 2014 and December 2018 was carried out. There were 25 cases of congenital hydrocephalus with aqueductal stenosis, two cases of Dandy–Walker cyst, two cases of cerebellopontine angle arachnoid cyst, and one case of posttubercular meningitis. ETV success score was calculated preoperatively to evaluate the percentage of success of ETV. Results: The overall success rate was 76.66% (23), with highest success rate of 84% in aqueductal stenosis. The mean age was 6.75 months (range: 1.5–12 months). Five infants were born preterm, four of them required a permanent VP shunt. There were two cases of intraoperative bleeding, four cases of cerebrospinal fluid leak from the wound, and one case of meningitis. Conclusion: ETV can be considered a safe and effective modality for the initial treatment of hydrocephalus in full-term normal birth weight infants, while the success of ETV in preterm low birth weight infants need further study of maturity at birth and birth weight as the determinant factors for the success of ETV in this special group.

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Section: Discussionsupporting

confidence: 42%