The current status of endoscopic third ventriculostomy in the management of non-communicating hydrocephalus

Improvements in the technology have made endoscopic third ventriculostomy safer than earlier technics of open third ventriculostomy as described by Scarf (14). Similarly, it is safer than the stereotactic technics used by Pierre-Kahn (10), Sayers (13), and Hoffman (4). The morbidity and mortality have decreased and the effectiveness has also increased (12, 15). Modern operations are based on Guiot's technique (2). In the management of hydrocephalus third ventriculostomy has to be compared with the treatment with intracranial shunts. Currently in our hands the procedure has a higher morbidity rate than a shunt operation. Our figures include those from our early experience (5)--more recent figures show a lower complication rate. We believe the higher morbidity is acceptable as the chance of being permanently cured is 80% in favourable cases.