Endoscopic third ventriculostomy with/without choroid plexus cauterization for hydrocephalus due to hemorrhage, infection, Dandy-Walker malformation, and neural tube defect: a meta-analysis.

Abstract

OBJECT:

Endoscopic third ventriculostomy (ETV) is a viable alternative to CSF shunting in hydrocephalic patients and is used with varying degrees of success dependent on age and etiology. The purpose of this meta-analysis is to analyze data on ETV and ETV/CPC (choroid plexus cauterization) outcomes in hopes of providing a clear understanding of their limitations in patients with hydrocephalus due to hemorrhage, infection, Dandy-Walker malformation, or neural tube disorders.

METHODS:

An extensive PubMed search dating back 11 years was performed on primary ETV or ETV/CPC procedures for hydrocephalus due to infection, hemorrhage, neural tube defects, and Dandy-Walker malformation. ETV success was defined as no intraoperative or post-operative complications and no need for revision surgery at follow-up.

RESULTS:

Ten studies were identified for analysis. The data represent 534 patients undergoing primary ETV and 167 patients undergoing primary ETV/CPC. The ETV group reached a 55 % success rate, while the ETV/CPC group reached a 67 % success rate. Success rates of ETV alone for hydrocephalus due to infection, neural tube defects, and intraventricular hemorrhage reached 54, 55, and 57 %, respectively. 84 % success was found in patients older than 2 years of age and 52 % success in patients less than 2 years of age.

CONCLUSIONS:

ETV is a valid treatment for hydrocephalus of any etiology. There exists a small difference in success rates between infection, hemorrhage, and neural tube disorders, though not enough to discount ETV for these etiologies. Initial data utilizing ETV/CPC are promising, and additional studies will need to be done to verify such results.

• Authors: Anthony Zandian, Matthew Haffner, James Johnson, Curtis J Rozzelle, R Shane Tubbs, Marios Loukas
• Journal: Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery (Childs Nerv Syst) Vol. 30 Issue 4 Pg. 571-8 (Apr 2014) ISSN: 1433-0350 [Electronic] Germany
• PMID: 24374638 (Publication Type: Journal Article, Meta-Analysis, Review)

Topics

• Cautery (methods)
• Central Nervous System Infections (complications)
• Cerebral Hemorrhage (complications)
• Choroid Plexus (surgery)
• Dandy-Walker Syndrome (complications)
• Humans
• Hydrocephalus (etiology, surgery)
• Neural Tube Defects (complications)
• Neuroendoscopy (methods)
• Third Ventricle (surgery)
• Ventriculostomy (methods)