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Year : 2019  |  Volume : 14  |  Issue : 2  |  Page : 399-402

Endoscopic third ventriculostomy in children with failed ventriculoperitoneal shunt

1 Department of Neurosurgery, Imam Reza Hospital, Urmia, Iran
2 Department of Neurosurgery, Children's Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran
3 Department of Neurosurgery, Shahid Beheshti University of Medical Science, Tehran, Iran

Correspondence Address:
Farideh Nejat
Children's Hospital Medical Center, Gharib Street 141557854, Tehran
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/ajns.AJNS_93_18

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Context: Endoscopic third ventriculostomy (ETV) is an accepted procedure for the treatment of obstructive hydrocephalus. The role of endoscopic treatment in the management of shunt malfunction was not extensively evaluated. The aim of this study is to evaluate the success rate of ETV in pediatric patients formerly treated by ventriculoperitoneal (V-P) shunt implantation. Materials and Methods: Thirty-three patients with their first shunt failure and obstructive hydrocephalus in brain imaging between 2008 and 2014 were enrolled in this study. Results: The most common causes of hydrocephalus in these patients were aqueductal stenosis and myelomeningocele with or without associated shunt infection. Of these 33 cases, 20 ETV procedures were successful, and 13 cases needed shunt revision after ETV failure. There was no serious complication during ETV procedures. The follow-up period of patients with successful ETV was 6–50 months (mean 18 months). The time interval between ETV and new shunting subsequent to ETV failure was 24.4 days (10–95). Conclusions: ETV can be considered as an alternative treatment paradigm in patients with previous shunt or new shunt failure with an acceptable success rate of 6o%, although long-term follow-up is needed for these patients.

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