Saenz, A;
Piper, RJ;
Thompson, D;
Tahir, MZ;
(2023)
Endoscopic third ventriculostomy for the management of children with cerebrospinal fluid disorders, ventriculomegaly, and associated Chiari I malformation.
World Neurosurgery: X
, 19
, Article 100200. 10.1016/j.wnsx.2023.100200.
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Abstract
OBJECTIVE: Our objective was to review the outcomes of children with CIM and associated cerebrospinal fluid (CSF) disorders and ventriculomegaly undergoing endoscopic third ventriculostomy (ETV) as a primary intervention. MATERIALS AND METHODS: A retrospective, single-center, observational cohort study was conducted of consecutive children with CIM with associated CSF disorders and ventriculomegaly treated first by ETV between January 2014 and December 2020. RESULTS: Raised intracranial pressure symptoms were the most frequent in ten patients, followed by posterior fossa and syrinx symptoms in three cases. One patient had a later stoma closure and required a shunt insertion. The success rate of the ETV in the cohort was 92% (11/12). There was no surgical mortality in our series. No other complications were reported. The median herniation of the tonsils was not statistically different in the pre vs. post-operative MRI (1.14 vs. 0.94, p=0.1). However, the median Evan’s index (0.4 vs. 0.36, p<0.01) and the median diameter of the third ventricle (1.35 vs. 0.76, p<0.01) were statistically different between the two measurements. The preoperative length of the syrinx did not change significantly compared with the postoperative (5 vs. 1; p=0.052); nevertheless, the median transverse diameter of the syrinx did improve significantly after the surgery (0.75 vs. 0.32, p=0.03). CONCLUSIONS: Our study supports ETV's safety and effectiveness for managing children with CSF disorders, ventriculomegaly, and associated CIM.
| Type: | Article |
|---|---|
| Title: | Endoscopic third ventriculostomy for the management of children with cerebrospinal fluid disorders, ventriculomegaly, and associated Chiari I malformation |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1016/j.wnsx.2023.100200 |
| Publisher version: | https://doi.org/10.1016/j.wnsx.2023.100200 |
| Language: | English |
| Additional information: | © 2023 The Authors. Published by Elsevier Inc. under a Creative Commons license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
| Keywords: | Chiari, Neuroendoscopy, Endoscopy, Hydrocephalus, Pediatrics |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Developmental Neurosciences Dept |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10171335 |
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