[Factors related to endoscopic third ventriculostomy prognosis in the paediatric population]

Abstract

Endoscopic third ventriculostomy (ETV) for paediatric patients has different success rates between the published series, making its recommendation controversial. Different definitions of ETV success, hydrocephalus aetiology or patient age at diagnosis may influence the outcome of the ETV procedure. The aim of this work was to analyse our clinical series and to examine the influence of different factors on ETV outcome. This was a retrospective study of 45 patients who had undergone ETV at our Paediatric Hospital between 2003 and 2009. Successful outcome was defined as a combination of features including clinical improvement or stability, with at least 1 positive radiological parameter. The influence of age, hydrocephalus aetiology, existence or not of previous shunt and the type of endoscopic procedure were analysed in relation to ETV outcome. Up to 29% of patients were younger than 1 year. The most frequent causes of hydrocephalus were: brain tumour, aqueductal stenosis and myelomeningocele. The overall success rate was 69%, with a mean follow-up period of 26 months and mean ETV survival of 14 months. We obtained statistically significant differences in ETV success between patients aged over and under 6 moths. Our ETV success rate can be considered safe and effective for the treatment of paediatric hydrocephalus. To our knowledge, ETV is most effective in patients aged 6 months and over.