Endoscopic third ventriculostomy for the treatment of hydrocephalus: An alternative to shunting

Pulak Ray, George I. Jallo, Richard Y H Kim, Bong Soo Kim, Sean Wilson, Karl Kothbauer, Ira Richmond Abbott, III

Research output: Contribution to journalArticle

Abstract

Endoscopic third ventriculostomy (ETV) is a common alternative method for the management of hydrocephalus in selected patients. A retrospective chart review was conducted to review our experience with ETV for patients with a variety of causes for hydrocephalus. A total of 67 children with median age of 10.8 years (range=8 weeks to 21 years) underwent 76 ETVs from July 1992 to June 2003. Two procedures were abandoned due to anatomical distortion. The medical records, operative reports, and imaging studies, were retrospectively reviewed with regard to outcome, complications and patency rate. Treatment failure was defined as the need to shunt the patient within 4 weeks of performing the ETV. The overall success rate was 83% with a mean follow-up 40.8 months. Nine patients underwent 11 repeat ETVs at an average interval period of 24 months with a patency rate of 90% following the second procedure. Ten of eleven patients who underwent re-ETV were ultimately shunt-independent. The highest success rates were achieved for obstructive hydrocephalus from midbrain/tectal tumor (100%, n=4), pineal tumor (100%, n=3), intraventricular tumor or cyst (100%, n=2), and post-infectious hydrocephalus (100%, n=1). Lower patency rates were noted in patients with Chiari malformation (0%, n=1) and posterior fossa tumors (63%, n=8). Due to the efficacy of ETV, it should be considered as the primary procedure, rather than ventricular peritoneal shunts, in carefully selected children. The reliability rate is dependent upon the age and etiology of hydrocephalus.

Original languageEnglish (US)
Pages (from-to)221-232
Number of pages12
JournalJournal of Pediatric Neurology
Volume4
Issue number4
StatePublished - 2006

Fingerprint

Ventriculostomy
Hydrocephalus
Therapeutics
Infratentorial Neoplasms
Brain Stem Neoplasms
Pinealoma
Treatment Failure
Medical Records
Cysts
Neoplasms

Keywords

  • Endoscope
  • Hydrocephalus
  • Outcome
  • Third ventriculostomy

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

Cite this

Ray, P., Jallo, G. I., Kim, R. Y. H., Kim, B. S., Wilson, S., Kothbauer, K., & Abbott, III, I. R. (2006). Endoscopic third ventriculostomy for the treatment of hydrocephalus: An alternative to shunting. Journal of Pediatric Neurology, 4(4), 221-232.

Endoscopic third ventriculostomy for the treatment of hydrocephalus : An alternative to shunting. / Ray, Pulak; Jallo, George I.; Kim, Richard Y H; Kim, Bong Soo; Wilson, Sean; Kothbauer, Karl; Abbott, III, Ira Richmond.

In: Journal of Pediatric Neurology, Vol. 4, No. 4, 2006, p. 221-232.

Research output: Contribution to journalArticle

Ray, P, Jallo, GI, Kim, RYH, Kim, BS, Wilson, S, Kothbauer, K & Abbott, III, IR 2006, 'Endoscopic third ventriculostomy for the treatment of hydrocephalus: An alternative to shunting', Journal of Pediatric Neurology, vol. 4, no. 4, pp. 221-232.
Ray P, Jallo GI, Kim RYH, Kim BS, Wilson S, Kothbauer K et al. Endoscopic third ventriculostomy for the treatment of hydrocephalus: An alternative to shunting. Journal of Pediatric Neurology. 2006;4(4):221-232.
Ray, Pulak ; Jallo, George I. ; Kim, Richard Y H ; Kim, Bong Soo ; Wilson, Sean ; Kothbauer, Karl ; Abbott, III, Ira Richmond. / Endoscopic third ventriculostomy for the treatment of hydrocephalus : An alternative to shunting. In: Journal of Pediatric Neurology. 2006 ; Vol. 4, No. 4. pp. 221-232.
@article{47f96d48f54a4a3189c80dc838ecb187,
title = "Endoscopic third ventriculostomy for the treatment of hydrocephalus: An alternative to shunting",
abstract = "Endoscopic third ventriculostomy (ETV) is a common alternative method for the management of hydrocephalus in selected patients. A retrospective chart review was conducted to review our experience with ETV for patients with a variety of causes for hydrocephalus. A total of 67 children with median age of 10.8 years (range=8 weeks to 21 years) underwent 76 ETVs from July 1992 to June 2003. Two procedures were abandoned due to anatomical distortion. The medical records, operative reports, and imaging studies, were retrospectively reviewed with regard to outcome, complications and patency rate. Treatment failure was defined as the need to shunt the patient within 4 weeks of performing the ETV. The overall success rate was 83{\%} with a mean follow-up 40.8 months. Nine patients underwent 11 repeat ETVs at an average interval period of 24 months with a patency rate of 90{\%} following the second procedure. Ten of eleven patients who underwent re-ETV were ultimately shunt-independent. The highest success rates were achieved for obstructive hydrocephalus from midbrain/tectal tumor (100{\%}, n=4), pineal tumor (100{\%}, n=3), intraventricular tumor or cyst (100{\%}, n=2), and post-infectious hydrocephalus (100{\%}, n=1). Lower patency rates were noted in patients with Chiari malformation (0{\%}, n=1) and posterior fossa tumors (63{\%}, n=8). Due to the efficacy of ETV, it should be considered as the primary procedure, rather than ventricular peritoneal shunts, in carefully selected children. The reliability rate is dependent upon the age and etiology of hydrocephalus.",
keywords = "Endoscope, Hydrocephalus, Outcome, Third ventriculostomy",
author = "Pulak Ray and Jallo, {George I.} and Kim, {Richard Y H} and Kim, {Bong Soo} and Sean Wilson and Karl Kothbauer and {Abbott, III}, {Ira Richmond}",
year = "2006",
language = "English (US)",
volume = "4",
pages = "221--232",
journal = "Journal of Pediatric Neuroradiology",
issn = "1304-2580",
publisher = "IOS Press",
number = "4",

}

TY - JOUR

T1 - Endoscopic third ventriculostomy for the treatment of hydrocephalus

T2 - An alternative to shunting

AU - Ray, Pulak

AU - Jallo, George I.

AU - Kim, Richard Y H

AU - Kim, Bong Soo

AU - Wilson, Sean

AU - Kothbauer, Karl

AU - Abbott, III, Ira Richmond

PY - 2006

Y1 - 2006

N2 - Endoscopic third ventriculostomy (ETV) is a common alternative method for the management of hydrocephalus in selected patients. A retrospective chart review was conducted to review our experience with ETV for patients with a variety of causes for hydrocephalus. A total of 67 children with median age of 10.8 years (range=8 weeks to 21 years) underwent 76 ETVs from July 1992 to June 2003. Two procedures were abandoned due to anatomical distortion. The medical records, operative reports, and imaging studies, were retrospectively reviewed with regard to outcome, complications and patency rate. Treatment failure was defined as the need to shunt the patient within 4 weeks of performing the ETV. The overall success rate was 83% with a mean follow-up 40.8 months. Nine patients underwent 11 repeat ETVs at an average interval period of 24 months with a patency rate of 90% following the second procedure. Ten of eleven patients who underwent re-ETV were ultimately shunt-independent. The highest success rates were achieved for obstructive hydrocephalus from midbrain/tectal tumor (100%, n=4), pineal tumor (100%, n=3), intraventricular tumor or cyst (100%, n=2), and post-infectious hydrocephalus (100%, n=1). Lower patency rates were noted in patients with Chiari malformation (0%, n=1) and posterior fossa tumors (63%, n=8). Due to the efficacy of ETV, it should be considered as the primary procedure, rather than ventricular peritoneal shunts, in carefully selected children. The reliability rate is dependent upon the age and etiology of hydrocephalus.

AB - Endoscopic third ventriculostomy (ETV) is a common alternative method for the management of hydrocephalus in selected patients. A retrospective chart review was conducted to review our experience with ETV for patients with a variety of causes for hydrocephalus. A total of 67 children with median age of 10.8 years (range=8 weeks to 21 years) underwent 76 ETVs from July 1992 to June 2003. Two procedures were abandoned due to anatomical distortion. The medical records, operative reports, and imaging studies, were retrospectively reviewed with regard to outcome, complications and patency rate. Treatment failure was defined as the need to shunt the patient within 4 weeks of performing the ETV. The overall success rate was 83% with a mean follow-up 40.8 months. Nine patients underwent 11 repeat ETVs at an average interval period of 24 months with a patency rate of 90% following the second procedure. Ten of eleven patients who underwent re-ETV were ultimately shunt-independent. The highest success rates were achieved for obstructive hydrocephalus from midbrain/tectal tumor (100%, n=4), pineal tumor (100%, n=3), intraventricular tumor or cyst (100%, n=2), and post-infectious hydrocephalus (100%, n=1). Lower patency rates were noted in patients with Chiari malformation (0%, n=1) and posterior fossa tumors (63%, n=8). Due to the efficacy of ETV, it should be considered as the primary procedure, rather than ventricular peritoneal shunts, in carefully selected children. The reliability rate is dependent upon the age and etiology of hydrocephalus.

KW - Endoscope

KW - Hydrocephalus

KW - Outcome

KW - Third ventriculostomy

UR - http://www.scopus.com/inward/record.url?scp=33845541465&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33845541465&partnerID=8YFLogxK

M3 - Article

AN - SCOPUS:33845541465

VL - 4

SP - 221

EP - 232

JO - Journal of Pediatric Neuroradiology

JF - Journal of Pediatric Neuroradiology

SN - 1304-2580

IS - 4

ER -