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Endoscopic third ventriculostomy in infants.

Y R Yadav1, Sumeet Jaiswal, Nelson Adam

  • 1Neurosurgery Unit, NSCB Medical College, Jabalpur, MP, India. yadavyr@yahoo.co.in

Neurology India
|June 29, 2006
PubMed
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Endoscopic third ventriculostomy (ETV) shows an 83.3% success rate in infants with obstructive hydrocephalus. However, outcomes are significantly poorer in low birth weight, premature infants compared to full-term infants.

Area of Science:

  • Neurosurgery
  • Pediatric Surgery
  • Hydrocephalus Management

Background:

  • Obstructive hydrocephalus in infants presents a significant surgical challenge.
  • Endoscopic third ventriculostomy (ETV) is a key neurosurgical intervention for this condition.
  • Evidence on ETV efficacy in infants remains debated, necessitating further investigation.

Purpose of the Study:

  • To evaluate the clinical outcomes and safety of ETV in a cohort of 54 infants.
  • To identify factors influencing ETV success rates in pediatric patients.

Main Methods:

  • A prospective study involving 54 infants undergoing ETV over two years.
  • Included cases of congenital hydrocephalus with aqueductal stenosis and post-tubercular meningitis hydrocephalus.
  • Average follow-up duration was 18 months.

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Main Results:

  • Achieved an overall clinical success rate of 83.3% (45 cases).
  • Complications included infection, CSF leak, bleeding (8% each), and stoma blockage (14.8%).
  • Low birth weight, premature infants demonstrated a higher failure rate (60%) versus full-term infants (12.3%).

Conclusions:

  • ETV is a safe and effective procedure for full-term, normal birth weight infants with obstructive hydrocephalus.
  • Results in low birth weight, premature infants are notably poorer, suggesting caution.
  • Aqueductal stenosis and TBM hydrocephalus showed comparable success rates, though TBM was lower.