Prediction of endoscopic third ventriculostomy (ETV) success with preoperative third ventricle floor bowing (TVFB): a supplement to ETV success score
- 27 Downloads
Preoperative judgement of which children is likely to benefit from endoscopic third ventriculostomy (ETV) is still the most difficult challenge. This study aimed to compare the efficiency of third ventricular floor bowing (TVFB) and ETV success score (ETVSS) in selecting ETV candidates and achieve a better preoperative patient selection method for ETV based on our institutional experience. Children (≤ 16 years old) with newly diagnosed hydrocephalus treated with ETV between January 2013 and June 2018 were included in this prospective study. Patients with TVFB will receive ETV procedure in the pediatric subgroup of our department. ETVSS was calculated in every patient. The ETVSS predicted ETV success rate and the actual ETV success rate in our institution were compared and further analyzed. One hundred twenty-nine children with TVFB were enrolled in our study. The mean age at ETV was 5.84 ± 5.17 years (range, 0.04–16). Brain tumors, aqueductal stenosis, and inflammatory are the most common hydrocephalus etiologies. The most common complication was noninfectious fever (3.1%). During the average follow-up of 19.5 ± 14.95 months, twenty-five patients had depicted ETV failure. The actual ETV success rate (81%) in our study was higher than the success rate (69%) predicted by ETVSS. TVFB is a pragmatic, efficient, and simple model to predict the ETV outcome. We suggest that for hydrocephalic patients with preoperative third ventricular floor bowing, ETV should be the first-treatment choice regardless of the ETV success score. And for patients without such sign, ETVSS should be applied to select ETV candidates.
KeywordsEndoscopic third ventriculostomy Third ventricle floor ETV success score Outcome
This work was financially supported by Sichuan Science and Technology Support Program (No. 2018SZ0043).
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
For this type of study, formal consent is not required.
- 4.Garcia LG, Lopez BR, Botella GI, Paez MD, da Rosa SP, Rius F, Sanchez MA (2012) Endoscopic third Ventriculostomy success score (ETVSS) predicting success in a series of 50 pediatric patients. Are the outcomes of our patients predictable? Child's nervous system. ChNS : official journal of the International Society for Pediatric Neurosurgery 28:1157–1162. https://doi.org/10.1007/s00381-012-1836-3 CrossRefGoogle Scholar
- 10.Kulkarni AV, Drake JM, Kestle JR, Mallucci CL, Sgouros S, Constantini S, Canadian Pediatric Neurosurgery Study G (2010) Predicting who will benefit from endoscopic third ventriculostomy compared with shunt insertion in childhood hydrocephalus using the ETV success score. J Neurosurg Pediatr 6:310–315. https://doi.org/10.3171/2010.8.PEDS103 CrossRefPubMedGoogle Scholar
- 12.Kulkarni AV, Riva-Cambrin J, Browd SR (2011) Use of the ETV success score to explain the variation in reported endoscopic third ventriculostomy success rates among published case series of childhood hydrocephalus. J Neurosurg Pediatr 7:143–146. https://doi.org/10.3171/2010.11.peds10296 CrossRefPubMedGoogle Scholar
- 13.Kulkarni AV, Riva-Cambrin J, Holubkov R, Browd SR, Cochrane DD, Drake JM, Limbrick DD, Rozzelle CJ, Simon TD, Tamber MS, Wellons JC 3rd, Whitehead WE, Kestle JR (2016) Endoscopic third ventriculostomy in children: prospective, multicenter results from the hydrocephalus clinical research network. J Neurosurg Pediatr 18:423–429. https://doi.org/10.3171/2016.4.peds163 CrossRefPubMedGoogle Scholar
- 14.Labidi M, Lavoie P, Lapointe G, Obaid S, Weil AG, Bojanowski MW, Turmel A (2015) Predicting success of endoscopic third ventriculostomy: validation of the ETV success score in a mixed population of adult and pediatric patients. J Neurosurg 123:1447–1455. https://doi.org/10.3171/2014.12.jns141240 CrossRefPubMedGoogle Scholar
- 15.Naftel RP, Reed GT, Kulkarni AV, Wellons JC (2011) Evaluating the Children's Hospital of Alabama endoscopic third ventriculostomy experience using the endoscopic third Ventriculostomy success score: an external validation study. J Neurosurg Pediatr 8:494–501. https://doi.org/10.3171/2011.8.peds1145 CrossRefPubMedGoogle Scholar