ENDOSCOPIC 3RD-VENTRICULOSTOMY - AN OUTCOME ANALYSIS

Endoscopic third ventriculostomy (ETV) has gained widespread acceptanc e as an effective way to manage hydrocephalus in selected patients. To determine which patient groups have the highest chance of successful ETV, a retrospective case review was performed. From June 1992 to Dece mber 1996, 97 patients underwent a total of 98 ETVs at our institution . There were 59 males and 38 females with a mean age of 8.1 years (ran ge 1 day to 29.5 years). Twenty-six of 98 procedures (26%) were abando ned due to either unfavorable anatomy, inability to perform a cisterno stomy, or hemorrhage. Follow-up data was available in 92 patients for a mean of 24.2 months. The rate of successful ETV in 71 patients, with either complete shunt avoidance or removal, varied widely by diagnosi s and patient age. The highest success rates were achieved in patients with aqueductal stenosis, tectal plate tumor, myelomeningocele and po sterior fossa tumor. Complications included one transient herniation s yndrome, one basilar artery perforation, 2 cases of ventriculitis, one transient decrease in level of consciousness, and one transient hemip aresis. We feel these results support the continued use of ETV in only carefully selected patients with hydrocephalus.