Long-term results of a second endoscopic third ventriculostomy in children: retrospective analysis of 40 cases

2010 ◽  
Vol 2010 ◽  
pp. 261-262
Author(s):  
P. Klimo,
Keyword(s):  
Retrospective Analysis ◽  
Endoscopic Third Ventriculostomy ◽  
Long Term Results ◽  
Third Ventriculostomy

Hydrocephalus in achondroplasia: efficacy of endoscopic third ventriculostomy

2021 ◽  
pp. 1-8
Keyword(s):  
Surgical Complications ◽  
Medical Records ◽  
Endoscopic Third Ventriculostomy ◽  
Ventricular Volume ◽  
Long Term Results ◽  
Third Ventriculostomy ◽  
Historical Comparison ◽  
Number Of Patients ◽  
Significant Difference

OBJECTIVE Ventriculoperitoneal shunts (VPSs) for hydrocephalus in patients with achondroplasia are known to have a higher failure rate than in other hydrocephalus populations. However, the etiology of hydrocephalus in this group is considered “communicating,” and, therefore, potentially not amenable to endoscopic third ventriculostomy (ETV). ETV has, nonetheless, been reported to be successful in a small number of patients with achondroplasia. The authors aimed to investigate the long-term results of ETV in this population. METHODS Patients with achondroplasia who had undergone surgical treatment for hydrocephalus (ETV or VPS placement) were identified. In patients who had undergone ETV, medical records and neuroimages were reviewed to determine ventricular volumes and frontal and occipital horn ratios (FOHRs) pre- and postoperatively, as well as the incidence of surgical complications and reoperation. Patients who underwent VPS placement were included for historical comparison, and their medical records were reviewed for basic demographic information as well as the incidence of surgical complications and reoperation. RESULTS Of 114 pediatric patients with achondroplasia referred for neurosurgical consultation, 19 (17%) were treated for hydrocephalus; 10 patients underwent ETV only, 7 patients underwent VPS placement only, and 2 patients had a VPS placed followed by ETV. In patients treated with ETV, ventricular volume and FOHRs were normal, if measured at birth, and increased significantly until the time of the ETV. After ETV, all patients demonstrated significant and sustained decreases in ventricular measurements with surveillance up to 15 years. There was a statistically significant difference in rates of repeat CSF surgery between the ETV and VPS cohorts (0/12 vs 7/9, p < 0.001). CONCLUSIONS ETV was efficacious, safe, and durable in the treatment of hydrocephalus in patients with achondroplasia. Although many studies have indicated that hydrocephalus in these patients is “communicating,” a subset may develop an “obstructive” component that is progressive and responsive to ETV.

LONG-TERM RESULTS OF A SECOND ENDOSCOPIC THIRD VENTRICULOSTOMY IN CHILDREN

Neurosurgery ◽  
2009 ◽  
Vol 65 (3) ◽  
pp. 539-547 ◽  
Author(s):  
Paola Peretta ◽  
Giuseppe Cinalli ◽  
Pietro Spennato ◽  
Paola Ragazzi ◽  
Claudio Ruggiero ◽  
...  
Keyword(s):  
Endoscopic Third Ventriculostomy ◽  
Imaging Study ◽  
Pediatric Neurosurgery ◽  
Long Term Results ◽  
Preoperative Imaging ◽  
Third Ventriculostomy ◽  
Prepontine Cistern ◽  
Operative Findings ◽  
Second Procedure

Abstract OBJECTIVE To evaluate retrospectively the operative findings and long-term results of a repeat endoscopic third ventriculostomy (ETV) in pediatric hydrocephalic patients readmitted after the first procedure with symptoms and/or signs of intracranial hypertension and/or radiological evidence of increased ventricular dilation and/or occluded stoma on follow-up radiological examinations. METHODS We analyzed a series of 482 ETVs in pediatric patients from 2 Italian departments of pediatric neurosurgery. The clinical charts of 40 patients undergoing a second ETV were selected and reviewed retrospectively. The pre- and postoperative radiological findings and operative films were analyzed retrospectively. RESULTS Forty patients underwent a total of 82 ETVs. Thirty-eight patients were operated on twice and 2 were operated on 3 times. During the second procedure, the stoma was found to be closed in 28 patients without underlying adhesions, to be open but with significant arachnoid adhesions in the prepontine cistern in 8 patients, to be open without adhesions in 2 patients, to have a pinhole orifice in 1 patient, and to be closed with underlying adhesions in 1 patient. The second procedure allowed reopening of the stoma or lysis of the arachnoid adhesions in 35 patients and was abandoned in 3 patients because of extensive arachnoid adhesions or because the stoma was found to be wide open (2 patients). In 30 patients (75%), the second ETV was effective, and the 2 patients who underwent a third ETV remained shunt free. In 10 patients (25%), a ventriculoperitoneal shunt was eventually placed. Age younger than 2 years at the time of the first procedure and arachnoid adhesions in the subarachnoid cisterns observed during the second procedure are the main negative prognostic factors for the success of a second ETV. CONCLUSION A second ETV can be performed with a reasonable chance of restoring patency of the stoma and avoiding placement of an extrathecal shunt. Every effort should be made to detect subarachnoid adhesions in the cistern on preoperative imaging study to select potential candidates and avoid unnecessary procedures.

Long-term results of endoscopic third ventriculostomy: an outcome analysis

2015 ◽  
Vol 123 (6) ◽  
pp. 1456-1462 ◽  
Author(s):  
Sonja Vulcu ◽  
Leonie Eickele ◽  
Giuseppe Cinalli ◽  
Wolfgang Wagner ◽  
Joachim Oertel
Keyword(s):  
Success Rate ◽  
Endoscopic Third Ventriculostomy ◽  
Clinical Success ◽  
Obstructive Hydrocephalus ◽  
Clinical Success Rate ◽  
Long Term Results ◽  
Third Ventriculostomy ◽  
Long Term Follow Up

OBJECT Endoscopic third ventriculostomy (ETV) is the procedure of choice in the treatment of obstructive hydrocephalus. The excellent clinical and radiological success rates are well known. Nevertheless, very few papers have addressed the very long term outcomes of the procedure in very large series. The authors present a large case series of 113 patients who underwent 126 ETVs, and they highlight the initial postoperative outcome after 3 months and long-term follow-up with an average of 7 years. METHODS All patients who underwent ETV at the Department of Neurosurgery, Mainz University Hospital, between 1993 and 1999 were evaluated. Obstructive hydrocephalus was the causative pathology in all cases. RESULTS The initial clinical success rate was 82% and decreased slightly to 78% during long-term follow-up. Long-term success was analyzed using Kaplan-Meier curves. Overall, ETV failed in 31 patients. These patients underwent a second ETV or shunt treatment. A positive impact on long-term success was seen for age older than 6 months, and for obstruction due to cysts or benign aqueductal stenosis. The complication rate was 9% with 5 intraoperative and 5 postoperative events. CONCLUSIONS The high clinical success rate in short-term and long-term follow-up confirms ETV’s status as the gold standard for the treatment of obstructive hydrocephalus, especially for distinct pathologies. The patient’s age and underlying pathology may influence the outcome. These factors should be considered carefully preoperatively by the surgeon.

Long-Term Results of the “Horseman” Procedure for Severe Idiopathic Flatfoot in Children: A Retrospective Analysis of 41 Consecutive Cases With Mean 8.9 Year Duration of Follow-Up

2019 ◽  
Vol 58 (1) ◽  
pp. 10-16 ◽  
Author(s):  
Caroline Dana ◽  
Zagorka Péjin ◽  
Céline Cadilhac ◽  
Philippe Wicart ◽  
Christophe Glorion ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Long Term Results

Endoscopic Transventricular Transaqueductal Magendie and Luschka Foraminoplasty for Hydrocephalus

Neurosurgery ◽  
2013 ◽  
Vol 74 (4) ◽  
pp. 426-436 ◽  
Author(s):  
Jaime Torres-Corzo ◽  
Juan Sánchez-Rodríguez ◽  
Dominic Cervantes ◽  
Roberto Rodríguez-Della Vecchia ◽  
Fernando Muruato-Araiza ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Endoscopic Third Ventriculostomy ◽  
Outlet Obstruction ◽  
Third Ventriculostomy ◽  
Alternative Technique ◽  
Vp Shunt ◽  
Long Term Follow Up ◽  
Secondary Causes

ABSTRACT BACKGROUND: Routinely, hydrocephalus related to fourth ventricular outlet obstruction (FVOO) has been managed with ventriculoperitoneal (VP) shunting or endoscopic third ventriculostomy (ETV). Few reports on Magendie foraminoplasty exist, and Luschka foraminoplasty has not been described. OBJECTIVE: To present an alternative technique in the management of FVOO via an endoscopic transventricular transaqueductal Magendie and Luschka foraminoplasty and to discuss the indications, technique, findings, and outcomes. METHODS: Between 1994 and 2011, all patients who underwent endoscopic Magendie and Luschka foraminoplasty were analyzed. RESULTS: A total of 33 Magendie (28) and/or Luschka (5) foraminoplasties were performed in 30 patients. Twenty-three were adult and 7 were pediatric patients. The etiology of the FVOO was divided into primary etiologies (congenital membrane in 5 and atresia in 2) and secondary causes (neurocysticercosis in 14 patients, bacterial meningitis in 9). Fifteen (50%) had previously failed procedures. Intraoperative findings that led to Magendie/Luschka foraminoplasty were ETV not feasible to perform, nonpatent basal subarachnoid space, or primary FVOO. Minor postoperative complications were seen in 3 patients. Only 26 patients had long-term follow-up; 17 (65.3%) of these had clinical improvement and did not require further procedures. Nine (34.7%) did not improve. Eight required another procedure (7 shunts, and 1 endoscopic procedure). One patient died. CONCLUSION: Flexible neuroendoscopic transventricular transforaminal Magendie and Luschka foraminoplasty is feasible and safe. These procedures may prove to be viable alternatives to standard ETV and VP shunt in appropriate patients. Adequate intraoperative assessment of ETV success is necessary to identify patients who will benefit.

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