ENDOSCOPIC THIRD VENTRICULOSTOMY (ETV);

Abstract

Objective: To know the surgical outcome of endoscopic third ventriculostomy(ETV) in non communicating hydrocephalous. Materials and methods: This study wasconducted in Abaseen Hospital, Peshawar, from 13th December 2010 to 12th October 2011.Patients with non-communicating hydrocephalous, irrespective of gender discrimination wereincluded in this study. Patients with communicated hydrocephalous, patients below two years ofage and hydrocephalus with infected CSF or hemorrhage were excluded. Hydrocephalous wasdiagnosed on CT scan brain. The procedure was done under general anesthesia. ClinicalOutcome of ETV was evaluated by the time of discharge and on subsequent follow up visits i.e.monthly for the first three months and then at six months. Any patient who subsequently neededVP shunting after the ETV procedure was described as having treatment failure. Results: Weoperated 27 patients during our study period. Age ranged from 2 years to 57 years with mean age20.8 years. There were 16(59.26%) males and 11(40.74 %) females. Etiologically,4th ventriculartumors was present in 9 patients(33.33%), tuberculous meningitis in 8(29.62%), aquiductalstenosis in 7(25.92%), brain stem glioma in 1(3.70%). cerebellar haemengioblastoma in 1(3.70%)and pineal tumor (3.70%) with infra tentorial extension in 1 (3.70%) patient. The procedure wassuccessful in 24(88.89%) patients and converted to ventriculoperitoneal shunts in 3(11.11%)cases. Post operatively CSF leakage was present in 2 (7.40%) patients, transient memory loss in1(3.70%), pneumocephalus in 1(3.70%) and pseudomeningocele in 1(3.70%) patients.Conclusions: Endoscopic third ventriculostomy is a good alternative to the VP shunt in cases ofnon-communicating hydrocephalous. Although ETV does have some complications but theseare transient and can be minimized with proper patient selection and meticulous surgicaltechnique