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Updated: Jun 10, 2026
Neuronavigation and Laparoscopy Guided Ventriculoperitoneal Shunt Insertion for the Treatment of Hydrocephalus
Published on: October 14, 2022
Role of shunts with antisiphon device in treatment of pediatric hydrocephalus
Rizwan A Khan1, K L Narasimhan, Manoj K Tewari
1Department of Pediatric Surgery, PGIMER, Chandigarh, India. drrizwanahmadkhan@yahoo.co.in
Insights
Ventriculo-peritoneal shunts with antisiphon devices show promise in treating pediatric congenital hydrocephalus by reducing overdrainage complications. This study found no overdrainage in the antisiphon group, unlike the non-antisiphon group.
Area of Science:
- Pediatric Neurosurgery
- Medical Devices
- Hydrocephalus Treatment
Background:
- Ventriculo-peritoneal shunts are standard for hydrocephalus, but overdrainage is a concern in children.
- Antisiphon devices are used in adults, but their efficacy in pediatric congenital hydrocephalus is less understood.
Purpose of the Study:
- To compare the effectiveness of ventriculo-peritoneal shunts with and without antisiphon devices in treating congenital hydrocephalus in pediatric patients.
- To assess the incidence of complications, particularly overdrainage, in both shunt types.
Main Methods:
- A randomized study involving 40 pediatric patients with congenital hydrocephalus.
- Group A received shunts with antisiphon devices (Vygon shunt); Group B received differential valve shunts without antisiphon devices (Chhabra, Ceredrain).
- Statistical analysis included Mann-Whitney, asymmetric t-test, and Chi-square tests.
Main Results:
- No significant difference in mean age or M:F ratio between groups.
- Non-antisiphon group showed greater decrease in Occipitofrontal Circumference (OFC) and Mid-ear Increment (MEI) in specific follow-up periods.
- Two cases of shunt overdrainage occurred in the non-antisiphon group; shunt blockage and infection rates were comparable (20% vs. 15%).
Conclusions:
- Overdrainage, though rare, is a significant complication of shunts in children.
- Shunts incorporating an antisiphon device demonstrated no instances of overdrainage in this pediatric cohort.
- Antisiphon devices may offer a protective mechanism against overdrainage in pediatric congenital hydrocephalus treatment.
Objective:
The use of ventriculo-peritoneal shunts having antisiphon device has been reported in adult patients, but there is a dearth of experience with such shunts in pediatric age group. This study is being undertaken to compare the effectiveness of these types of shunt for the treatment of congenital hydrocephalus.
Patients And Methods:
Forty patients with congenital hydrocephalus with or without neural tube were divided randomly into two groups (A and B). Patients in antisiphon group were treated with shunts with differential valve including antisiphon device (Vygon shunt) while patients in non-antisiphon group were treated with differential valve shunts (Chhabra shunt and Ceredrain). Mann-Whitney test, asymmetric t-test and Chi-square test were used to assess the correlation and the significance.
Results:
The mean age was 3.5 months and 3.4 months in antisiphon group and non-antisiphon group, respectively. The M:F ratio was 2.3:1 in antisiphon group while it was 3:1 in non-antisiphon group. The mean decrease in OFC was more in non-antisiphon group than antisiphon group during the follow up from 3 months to 6 months while mean decrease in MEI was more in non-antisiphon group from 0 month to 3 months than antisiphon group. There were two cases of shunt overdrainage in non-antisiphon group. The shunt blockage rate was 20% in antisiphon group and 15% in non-antisiphon group, respectively. There was 20% and 15% shunt infection rate in antisiphon group and non-antisiphon group, respectively. This study demonstrated overdrainage syndrome in two of the patients of differential valve shunts.
Conclusion:
Though rare, complication associated with overdrainage is certainly a problem in children. In our study, the patients who received shunts with antisiphon device do not show any overdrainage.
