Endoscopic third ventriculostomy for obstructive hydrocephalus

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Hassan Z.A. Dixon
Yasir M. Hamandi
Ammar M.A. Mahmmoud
Samer S. Hoz
Zahraa F. Al-Sharshahi

Abstract

Introduction: Obstructive hydrocephalus has long been managed by valve-regulated shunts. These shunts are associated with a myriad of short and long-term complications. This has fueled interest in Endoscopic Third Ventriculostomy (ETV) which provides a more physiological pathway for cerebrospinal fluid (CSF) diversion while avoiding many shunt-related complications.


Aim: The objective of this study is to analyze the outcomes of ETV at our institution, focusing on the indications, success rates, and short-term complications.


Methods: Between July 2010 and September 2015, 47 patients with obstructive hydrocephalus underwent ETV at the Neurosurgery Teaching Hospital in Baghdad/ Iraq. We retrospectively analyzed the data of these patients using hospital health records. Simple statistics were performed using  SPSS Version 20. A standardized surgical technique was employed in all cases.


Results: The mean age was 4.4 years (range 40 days - 38 years). The male: female ratio was 1.23:1 (55% males and 45% females). The most common cause of obstructive hydrocephalus in patients undergoing ETV was aqueductal stenosis (62%; N=29). The second most common cause was posterior fossa tumours (23%; N=11). The overall success rate for ETV was 68%. The net post-operative complication rate was 13% (N=6). CSF leak and seizures were the only two charted post-operative complications at the rates of 9%(N=4) and 4% (N=2), accordingly. No deaths were recorded.


Conclusion: ETV is a viable alternative to shunt insertion in a select group of patients with obstructive hydrocephalus, with acceptable success rate and safety profile.

Article Details

How to Cite
Dixon, H. Z. ., Hamandi, Y. M. ., Mahmmoud, A. M. ., Hoz, S. S. ., & Al-Sharshahi, Z. F. . (2020). Endoscopic third ventriculostomy for obstructive hydrocephalus. Romanian Neurosurgery, 34(2), 269-274. https://doi.org/10.33962/roneuro-2020-039
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Author Biographies

Hassan Z.A. Dixon

Neurosurgeon F.I.C.M.S., Al-Mawanee General Hospital, Basra, Iraq

Yasir M. Hamandi

Professor of Neurosurgery, Al-Nahrain College of Medicine, Baghdad, Iraq

Ammar M.A. Mahmmoud

Neurosurgeon, Neurosurgery Teaching Hospital, Baghdad, Iraq

Samer S. Hoz

Neurosurgeon (FRCS), Department of Neurosurgery, Neurosurgery Teaching Hospital, Baghdad, Iraq

Zahraa F. Al-Sharshahi

MB, BCh BAO (NUI, RCSI), LRCP & SI, Royal College of Surgeons in Ireland (Alumnus), Dublin, Ireland