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[Treatment of child hydrocephalus by endoscopic third ventriculostomy in Senegal]
S Salem-Memou1, A Badara Thiam1, E Kpelao1
1Clinique neurochirurgicale, CHU de Fann, avenue Cheikh AntaDiop, BP 5035, Dakar-Fann, Sénégal.
Insights
Endoscopic third ventriculostomy (ETV) is a safe and effective treatment for pediatric hydrocephalus in Senegal, showing a 71.4% success rate. This technique offers improved quality of life and reduced morbidity compared to shunts, especially in developing nations.
Area of Science:
- Neurosurgery
- Pediatric Surgery
- Medical Technology
Context:
- Hydrocephalus is a significant neurological condition in children.
- Shunt placement has been the traditional treatment for hydrocephalus.
- Endoscopic third ventriculostomy (ETV) emerged as a less invasive alternative.
Purpose:
- To evaluate the efficacy and safety of ETV in pediatric hydrocephalus cases in Senegal.
- To analyze the outcomes and complications of ETV in a West African setting.
- To compare ETV with shunt placement in terms of quality of life and morbidity.
Summary:
- A retrospective study of 70 children (5 months to 15 years) treated with ETV between 2010-2012 in Dakar.
- The primary etiologies were aqueductal stenosis and Dandy-Walker malformation.
- ETV demonstrated a 71.4% success rate, with complications including CSF leakage and infections; no deaths occurred.
Impact:
- ETV is a viable, safe, and effective treatment for pediatric hydrocephalus, particularly in resource-limited settings.
- The findings support ETV as a preferred method over shunts, enhancing patient quality of life.
- This study highlights the potential for advanced neurosurgical techniques in developing countries.
Introduction:
Since its advent, endoscopic third ventriculostomy (ETV) has been an effective alternative to shunt placement for the treatment of hydrocephalus. The aim of this study was to report the results of our experience with this technique in children in Senegal.
Materials And Methods:
This was a retrospective study of 70 cases of children aged between 5 months to 15 years who were treated by ETV in the Neurosurgery Department of Fann Hospital in Dakar, between January 2010 to December 2012. The results were evaluated based on the clinical criteria of Drake and the Canadian Pediatric Neurosurgery Study Group. The mean follow-up duration was 24 months (9-32 months).
Results:
The mean age at diagnosis was 29 months. A male predominance (sex-ratio 1/3) was observed. We also noted a macrocephaly in 64.4 % of cases, psychomotor retardation in 40 % and decreased vision in 31.4 %. Headache and vomiting were found in 42.8 % and 61.4 % respectively. The main etiology was a stenosis of the mesencephalon aqueduct (30 %), followed by a Dandy-Walker malformation (25.7 %). Significant intraoperative bleeding was found in 2.8 % of patients. The most common postoperative complication was CSF leakage (18.6 %), followed by infections (14.2 %). The success rate according to the clinical criteria of Drake was 71.4 %. This success rate was influenced by the age of patients and the hydrocephalus etiology. No deaths occurred.
Conclusion:
The endoscopic third ventriculostomy is a simple, safe and effective technique. Its advantages in terms of quality of life and morbidity compared with bypass valves makes it the technique of choice, particularly in developing countries.
