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. 2021 Mar;37(3):913-917.
doi: 10.1007/s00381-020-04949-0. Epub 2020 Oct 31.

Repeat endoscopic third ventriculostomy success rate according to ventriculostoma closure patterns in children

Volkan Etus  1 , Gokmen Kahilogullari  2 , Aykut Gokbel  3 , Hamza Genc  1 , Tugba Morali Guler  4 , Onur Ozgural  5 , Agahan Unlu  5
Affiliations

Repeat endoscopic third ventriculostomy success rate according to ventriculostoma closure patterns in children

Volkan Etus et al. Childs Nerv Syst. 2021 Mar.

Abstract

Purpose: This study aimed to examine the success rate of repeat endoscopic third ventriculostomy (redo-ETV) according to pattern of ventriculostoma closure based on observations in 97 paediatric redo-ETV patients.

Methods: Clinical data and intraoperative video recordings of 97 paediatric hydrocephalus patients who underwent redo-ETV due to ventriculostoma closure at two institutions were retrospectively analysed. We excluded patients with a history of intraventricular haemorrhage, cerebrospinal fluid (CSF) infection or CSF shunt surgery and those with incompletely penetrated membranes during the initial ETV.

Results: Verification of ventriculostoma closure was confirmed with cine phase-contrast magnetic resonance imaging and classified into 3 types: type 1, total closure of the ventriculostoma by gliosis or scar tissue that results in a non-translucent/opaque third ventricle floor; type 2, narrowing/closure of the ventriculostoma by newly formed translucent/semi-transparent membranes; and type 3, presence of a patent ventriculostoma orifice with CSF flow blockage by newly formed reactive membranes or arachnoidal webs in the basal cisterns. The overall success rate of redo-ETV was 37.1%. The success rates of redo-ETV according to closure type were 25% for type 1, 43.6% for type 2 and 38.2% for type 3. The frequency of type 1 ventriculostoma closure was significantly higher in patients with myelomeningocele-related hydrocephalus.

Conclusion: For patients with ventriculostoma closure after ETV, reopening of the stoma can be performed. Our findings regarding the frequencies of ventriculostoma closure types and the success rate of redo-ETV in paediatric patients according to ventriculostoma closure type are preliminary and should be verified by future studies.

Keywords: Children; ETV; Failure; Repeat ETV.

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References

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