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Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
14:59

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Published on: October 14, 2022

Neuroendoscopic third ventriculostomy for failed shunts.

Neil Buxton1, Donald Macarthur, Iain Robertson

  • 1Department of Neurosurgery, University Department of Child Health, University Hospital, Nottingham, UK.

Surgical Neurology
|August 19, 2003
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Neuroendoscopic third ventriculostomy (NTV) is a safe and effective treatment for hydrocephalus, even after shunt failure. Success rates are comparable to primary NTV, with complications being rare.

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Area of Science:

  • Neurosurgery
  • Pediatric Neurosurgery
  • Neurology

Background:

  • Neuroendoscopic third ventriculostomy (NTV) is increasingly used for hydrocephalus management.
  • This study evaluates NTV outcomes in patients with prior shunt failure.

Purpose of the Study:

  • To assess the efficacy and safety of NTV in hydrocephalus patients with a history of shunt malfunction.
  • To compare NTV success rates in this cohort to primary NTV procedures.

Main Methods:

  • A prospectively maintained database (since 1994) was queried for patients who underwent NTV after shunt failure.
  • Failure of NTV was defined as requiring further hydrocephalus treatment.

Main Results:

  • 88 patients (45 male, 43 female) were identified, with a median age of 14 years.
  • Overall success rate was 52% (46/88), with 48% (42/88) experiencing failure.
  • Success rate for noncommunicating hydrocephalus was 73%; serious complications occurred in 5.6%.

Conclusions:

  • NTV is a safe and effective option for hydrocephalus management in patients with prior shunt failure.
  • Communicating hydrocephalus has a higher failure rate than noncommunicating types.
  • NTV is a viable treatment even with a malfunctioning shunt in place and can aid in managing infected shunts.