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Endoscopic third ventriculostomy in the paediatric population

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Abstract

Background

Endoscopic third ventriculostomy (ETV) is a preferred mode of treatment for paediatric obstructive hydrocephalus as a result of lesions in the vicinity of the aqueduct of sylvius and posterior third ventricle. It obviates the need of implanting a foreign body inside the brain and thus reduces hardware-related complications as are seen with ventriculo-peritoneal shunts (VP).

Method

Endoscopic third ventriculostomy was done in nine cases of paediatric hydrocephalus (multiple etiologies) and the patients were followed up for a period of 18 months.

Results

In our series of nine cases, there was one ETV failure in a child of 14 months who required a conversion to VP shunt. Contusions in the fornix were seen in another patient who was of 3 months of age with post fossa tumour, but fortunately the patient did not have any gross memory deficits and was doing well after 6 months of follow-up. Intraventricular bleeding was seen in two cases which could be controlled with generous irrigation. External ventricular drain was not required in any patient. Rest of the eight patients improved slowly over the period of 6 months.

Conclusion

ETV is an attractive mode of treating obstructive hydrocephalus as it avoids the complications which can arise from implanting a foreign body. It requires a learning curve to master the technique. The literature of ETV in the paediatric population is reviewed along with our experience of nine cases of paediatric hydrocephalus with ETV.

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Authors and Affiliations

  1. Department of Neurosurgery, SMS Medical College, N-7, Gandhi Nagar Vidhayak Flats, Behind Jawahar Kala Kendra, Bajaj Nagar Main Road, Jaipur, Rajasthan, India

    Rashim Kataria

  2. Department of Neurosurgery, SMS Medical College, B32, Resident Doctors Hostel, Jaipur, Rajasthan, 302004, India

    Mudit Mehrotra

  3. Department of Neurosurgery, Sony Centre, SMS Medical College, 111, Mahavir Nagar, Tonk Road, Jaipur, Rajasthan, 302018, India

    Devendra K. Purohit

  4. Department of Paediatric surgery, SMS Medical College, Jaipur, Rajasthan, India

    Praveen Mathur

  5. Senior Bioinformatics Analyst, ICF, Rockville, MD, USA

    Nachiket Dharker

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  1. Rashim Kataria
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  4. Praveen Mathur
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Correspondence to Mudit Mehrotra.

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Kataria, R., Mehrotra, M., Purohit, D.K. et al. Endoscopic third ventriculostomy in the paediatric population. J Ped Endosc Surg 3, 183–192 (2021). https://doi.org/10.1007/s42804-021-00117-6

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  • DOI: https://doi.org/10.1007/s42804-021-00117-6

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