Long-term reliability of endoscopic third ventriculostomy.

Area of Science:

• Neurosurgery
• Pediatric Neurosurgery
• Hydrocephalus Management

Background:

• Hydrocephalus is a complex neurological condition requiring timely intervention.
• Endoscopic third ventriculostomy (ETV) offers a minimally invasive surgical option for hydrocephalus treatment.
• Understanding the long-term outcomes and influencing factors of ETV is crucial for patient management.

Purpose of the Study:

• To evaluate the short-term operative success of ETV in treating hydrocephalus.
• To assess the long-term reliability and durability of ETV procedures.
• To identify patient-specific factors, including diagnosis, age, and prior shunt history, that impact ETV outcomes.

Main Methods:

• Retrospective analysis of 203 consecutive patients undergoing ETV.
• Inclusion of diverse hydrocephalus etiologies: aqueductal stenosis, myelomeningocele, tumors, cysts, infection, and hemorrhage.
• Long-term follow-up extending up to 22.6 years.

Main Results:

• High overall ETV success rate of 89%.
• Age significantly impacts long-term ETV reliability, with infants under 6 months showing poorer outcomes.
• No significant association found between reliability and hydrocephalus diagnosis or previous shunt history.

Conclusions:

• ETV is an effective procedure for hydrocephalus with good short-term success rates.
• Infants under six months of age represent a high-risk group for ETV long-term failure.
• Age is the primary determinant of long-term ETV reliability, guiding surgical decision-making.