• Endoscopic Third Ventriculostomy in the Treatment of Childhood Hydrocephalus

    • Feb 28, 2022

    • Endoscopic third ventriculostomy is an alternative CSF diversion to ventricular shunting with decreased economic cost.
    • ETV has a 30% failure rate in children similar to ventricular shunting (30-40%), however 4-year failure rate is 43% for ETV and 59% for shunts
    • Objective: The authors aimed to develop a predictive model that can accurately predict the probability of ETV success in treating pediatric hydrocephalus based on the child’s individual characteristics.
    • Multi-center, international, retrospective study
    • Study population: 618 consecutive patients that underwent an ETV for hydrocephalus at 12 international institutions in 3 countries (Canada, Israel, and the United Kingdom)
    • Age, etiology, and prior shunt history were significant predictors of ETV success (p-values <.001, 0.7, and .03 respectively)
    • Using 70% training and 30% validation sets, a 6-month ETV success scoring system was created (see graphic)
    • Of note, high operative volume center was tested as a potential independent variable but was not found to be statistically significant.
    • High ETV score (>75) had an 80% success, moderate ETV score (50-75) had a 63% success, and low ETV score (<50) had a 41% success
    • Age ≥ 10 and obstructive pathology (aqueductal stenosis, tectal tumor, other etiology) were associated with largest impact on success (50% and 30%)
    • If ETV is successful at 6-months, the 3- and 5-year success rates are 87% and 83%, respectively
    • Limitations: Some inherent differences in practice patterns may exist within different countries involved. No external validation using data from countries other than the 3 countries involved in the study. The study population had very few patients with certain etiologies such as myelomeningocele and postinfectious hydrocephalus.






    Journal of Pediatrics


We use cookies to improve the performance of our site, to analyze the traffic to our site, and to personalize your experience of the site. You can control cookies through your browser settings. Please find more information on the cookies used on our site here. Privacy Policy