Outcome of Endoscopic Third Ventriculostomy in Pediatric Patients at Zewditu Memorial Hospital, Ethiopia

Abstract

To determine short-term outcome of endoscopic third ventriculostomy (ETV) in pediatric patients. This was a hospital-based retrospective study of outcome of ETV performed with or without choroid plexus cauterization (CPC) in pediatric patients at Zewditu Memorial Hospital, Addis Ababa, Ethiopia, between January 2012 and December 2014. Medical records were used to complete a structured questionnaire. Outcomes were graded as success or failure. The difference in proportions was examined using χ(2) test. Of 122 children, 26 underwent a combined ETV and CPC procedure, and 96 underwent ETV alone. The mean and median ages were 1.89 months and 2.0 months, respectively. Most patients were <6 months old (45.1%); 35.2% were >1 year old. The cause of hydrocephalus was myelomeningocele in 42 (34.4%) patients and aqueductal stenosis in 41 (33.6%) patients. The mean and median follow-up periods were 7.2 months and 3.0 months, respectively. The success rate for combined ETV and CPC (66%) was superior to the success rate for ETV alone (47%) among infants <1 year old (P < 0.0001). The overall surgical mortality rate was 2.4%, and the infection rate was 7%. In resource-limited countries, ETV can be performed with acceptable results and less mortality and morbidity. Myelomeningocele and aqueductal stenosis were the most common causes of hydrocephalus. In patients <1 year old, the outcome success in patients undergoing combined ETV and CPC (53%) was significantly better compared with patients undergoing ETV alone (25%).