ETV in infancy and childhood below 2 years of age for treatment of hydrocephalus
(2020) In Child's Nervous System 36(11). p.2725-2731- Abstract
Purpose: Age and etiology play a crucial role in success of endoscopic third ventriculostomy (ETV) as a treatment of obstructive hydrocephalus. Outcome is worse in infants, and controversies still exist whether ETV is superior to shunt placement. We retrospectively analyzed 70 patients below 2 years from 4 different centers treated with ETV and assessed success. Methods: Children < 2 years who received an ETV within 1994–2018 were included. Patients were classified according to age and etiology; < 3, 4–12, and 13–24 months, etiologically; aqueductal stenosis, post-hemorrhagic-hydrocephalus (PHH), tumor-related, fourth ventricle outflow obstruction, with Chiari-type II and following CSF infection. We investigated statistically the... (More)
Purpose: Age and etiology play a crucial role in success of endoscopic third ventriculostomy (ETV) as a treatment of obstructive hydrocephalus. Outcome is worse in infants, and controversies still exist whether ETV is superior to shunt placement. We retrospectively analyzed 70 patients below 2 years from 4 different centers treated with ETV and assessed success. Methods: Children < 2 years who received an ETV within 1994–2018 were included. Patients were classified according to age and etiology; < 3, 4–12, and 13–24 months, etiologically; aqueductal stenosis, post-hemorrhagic-hydrocephalus (PHH), tumor-related, fourth ventricle outflow obstruction, with Chiari-type II and following CSF infection. We investigated statistically the predictors for ETV success through computing Kaplan-Meier estimates using patient’s follow-up time and time to ETV failure. Results: We collected 70 patients. ETV success rate was 41.4%. The highest rate was in tumor-related hydrocephalus and fourth ventricle outlet obstruction (62.5%, 60%) and the lowest rate was in Chiari-type II and following infection (16.7%, 0%). The below 3 months age group showed relatively lower success rate (33.3%) in comparison to older groups which showed similar results (46.4%, 46.6%). Statistically, a previous VP shunt was a predictor for failure (p value < 0.05). Conclusion: Factors suggesting a high possibility of failure were age < 3 months and etiology such as Chiari-type II or following infection. Altered CSF dynamics in patients with PHH and under-developed arachnoid villi may play a role in ETV failure. We do not recommend ETV as first line in children < 3 months of age or in case of Chiari II or following infection.
(Less)
- author
- publishing date
- 2020-11
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Aqueduct stenosis, Endoscopic third ventriculostomy, Obstructive hydrocephalus, Post-hemorrhagic
- in
- Child's Nervous System
- volume
- 36
- issue
- 11
- pages
- 7 pages
- publisher
- Springer
- external identifiers
-
- pmid:32222800
- scopus:85082966779
- ISSN
- 0256-7040
- DOI
- 10.1007/s00381-020-04585-8
- language
- English
- LU publication?
- no
- id
- 03d49150-a88d-4da4-98bc-c7c9fd821673
- date added to LUP
- 2020-05-08 16:46:03
- date last changed
- 2024-09-04 21:34:25
@article{03d49150-a88d-4da4-98bc-c7c9fd821673,
abstract = {{<p>Purpose: Age and etiology play a crucial role in success of endoscopic third ventriculostomy (ETV) as a treatment of obstructive hydrocephalus. Outcome is worse in infants, and controversies still exist whether ETV is superior to shunt placement. We retrospectively analyzed 70 patients below 2 years from 4 different centers treated with ETV and assessed success. Methods: Children < 2 years who received an ETV within 1994–2018 were included. Patients were classified according to age and etiology; < 3, 4–12, and 13–24 months, etiologically; aqueductal stenosis, post-hemorrhagic-hydrocephalus (PHH), tumor-related, fourth ventricle outflow obstruction, with Chiari-type II and following CSF infection. We investigated statistically the predictors for ETV success through computing Kaplan-Meier estimates using patient’s follow-up time and time to ETV failure. Results: We collected 70 patients. ETV success rate was 41.4%. The highest rate was in tumor-related hydrocephalus and fourth ventricle outlet obstruction (62.5%, 60%) and the lowest rate was in Chiari-type II and following infection (16.7%, 0%). The below 3 months age group showed relatively lower success rate (33.3%) in comparison to older groups which showed similar results (46.4%, 46.6%). Statistically, a previous VP shunt was a predictor for failure (p value < 0.05). Conclusion: Factors suggesting a high possibility of failure were age < 3 months and etiology such as Chiari-type II or following infection. Altered CSF dynamics in patients with PHH and under-developed arachnoid villi may play a role in ETV failure. We do not recommend ETV as first line in children < 3 months of age or in case of Chiari II or following infection.</p>}},
author = {{El Damaty, Ahmed and Marx, Sascha and Cohrs, Gesa and Vollmer, Marcus and Eltanahy, Ahmed and El Refaee, Ehab and Baldauf, Joerg and Fleck, Steffen and Baechli, Heidi and Zohdi, Ahmed and Synowitz, Michael and Unterberg, Andreas and Schroeder, Henry W.S.}},
issn = {{0256-7040}},
keywords = {{Aqueduct stenosis; Endoscopic third ventriculostomy; Obstructive hydrocephalus; Post-hemorrhagic}},
language = {{eng}},
number = {{11}},
pages = {{2725--2731}},
publisher = {{Springer}},
series = {{Child's Nervous System}},
title = {{ETV in infancy and childhood below 2 years of age for treatment of hydrocephalus}},
url = {{http://dx.doi.org/10.1007/s00381-020-04585-8}},
doi = {{10.1007/s00381-020-04585-8}},
volume = {{36}},
year = {{2020}},
}