N. Buxton et al., Neuroendoscopic third ventriculostomy for hydrocephalus in adults: Report of a single unit's experience with 63 cases, SURG NEUROL, 55(2), 2001, pp. 74-78
BACKGROUND Neuroendoscopic third ventriculostomy (NTV) is becoming a first
line treatment for hydrocephalus in this center. Its use in a consecutive s
eries of adults is reported.
METHOD Initially a retrospective data collection after 7 months becoming pr
ospective studying all patients who underwent NTV in this center. The adult
s (17 years or older) have been studied.
RESULTS Sixty-three patients met the criteria for inclusion: 38 male, 25 fe
male. Mean age at first NTV 37.5 years. There was an 80% success rate (i.e.
, no further therapy for the hydrocephalus required). Follow-up was for a m
ean of 3.1 years. The largest subgroup were patients with third ventricular
tumours (35%), of whom 86% were successfully treated. Mean time to failure
for the whole series was 8.5 months (range immediate-30 months). Complicat
ions occurred in 17.5%; those deemed serious in 11%. There were three death
s (4.7%) within 30 days of the procedure. There were six other deaths durin
g follow-up, five because of tumour progression and one because of pneumoni
a.
CONCLUSIONS This procedure lends itself to the treatment of hydrocephalus i
n adults and appears to be more successful than in young children. It is ef
ficacious in both previously shunted and non shunted patients. It is now th
e first-line treatment for noncommunicating hydrocephalus in this center an
d also for patients with shunt failure who are anatomically suitable, havin
g cerebrospinal fluid spaces large enough to admit the endoscope. The compl
ication and mortality rates compare favorably with those for shunts. (C) 20
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