International Journal of Neurosurgery

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Outcome of Choroid Plexus Cauterization with Endoscopic 3rd Ventriculostomy vs Ventricular Shunting in Management of Hydrocephalus Secondary to Neural Tube Defect

Received: Nov. 20, 2019    Accepted: Dec. 03, 2019    Published: Dec. 10, 2019
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Abstract

Background: Different surgical management of infants suffering neural tube defects (NTD) associated hydrocephalus were reported in the literature. Great debate whether combining endoscopic third ventriculostomy (ETV) with choroid plexus cauterization (CPC) is more effective than ventriculoperitoneal (VP) shuntfor management of congenital hydrocephalus secondary to neural tube defects ininfants younger than 1 year of age. Purpose: To evaluate and compare the therapeutic efficacy of ETV combined with CPC versus VP shunts in infants with infantile hydrocephalus associated with NTD. Methods: Thirty infants with infantile NTD associated hydrocephalus (de novo), were equally divided and randomly allocated to each intervention group either ETV/CPC or VP shunts). They were monitored for at least 6 months for any sign of raised intracranial pressure (rICP) and/or hydrocephalic metrics (fontanelle quality, HC, and ventricular size) were also documented and compared between two groups. Statistical Analysis: The association between intervention group and outcome was tested with Chi-square test and P=0.05 or less was considered statistically significant. Results: Of the total thirty patients included in the study, thirteen patients (43.3%) were male and seventeen were female (56.7%) with mean age of 80.3±11.5 days. Twenty patients (66%) were under 6 months of age. The overall success rate in 1-year follow-up was 54% and 60% for VP shunt and ETV/CPC, respectively; with the difference being not statistically significant. Conclusion: Combined ETV-CPC is considered a successful surgical option for treatment of infantile hydrocephalus associated with NTD; achieving success rate better than VPS implantation.

DOI 10.11648/j.ijn.20190302.14
Published in International Journal of Neurosurgery ( Volume 3, Issue 2, December 2019 )
Page(s) 32-37
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Endoscopic Third Ventriculostomy, Choroid Plexus Cauterization, Neural Tube Defect, Hydrocephalus

References
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[4] P. A Beuriat, A. Szathmari, B. Grassiot et al. "Role of endoscopic third ventriculostomy in the management of myelomeningocele-related hydrocephalus: a retrospective study in a single French institution". World Neurosurg 87: 484–493, 2016.
[5] B. C. Warf and J. W. Campbell."Combined endoscopic third ventriculostomyand choroid plexus cauterization as primary treatment of hydrocephalus for infants with myelo-meningocele: long-term results of a prospective intent-to-treat study in 115 East African infants". J Neurosurg Pediatr 2: 310–316, 2008.
[6] E. A. Elgamal."Natural history of hydrocephalus in children with spinal open neural tube defect". Surg Neurol Int 3: 112, 2012.
[7] F. Radmanesh, F. Nejat, M. El-Khashab et al. "Shunt complications in children with myelomeningocele: effect of timing of shunt placement". Clinical article. J Neurosurg Pediatr 3:516–520, 2009.
[8] M. C. Dewan and R. P. Naftel." The global rise of endoscopic third ventriculostomy with choroid plexus cauterization in pediatric hydrocephalus". Pediatr Neurosurg 52: 401–408, 2017.
[9] R. F. Jones, B. C. Kwok, W. A. Stening et al." Third ventriculostomy for hydrocephalus associated with spinal dysraphism: indications and contraindications". Eur J Pediatr Surg 6 (Suppl 1): 5–6, 1996.
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  • APA Style

    Ahmed Zahe, Mahmoud Saad, Abdelghany Elshamy. (2019). Outcome of Choroid Plexus Cauterization with Endoscopic 3rd Ventriculostomy vs Ventricular Shunting in Management of Hydrocephalus Secondary to Neural Tube Defect. International Journal of Neurosurgery, 3(2), 32-37. https://doi.org/10.11648/j.ijn.20190302.14

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    ACS Style

    Ahmed Zahe; Mahmoud Saad; Abdelghany Elshamy. Outcome of Choroid Plexus Cauterization with Endoscopic 3rd Ventriculostomy vs Ventricular Shunting in Management of Hydrocephalus Secondary to Neural Tube Defect. Int. J. Neurosurg. 2019, 3(2), 32-37. doi: 10.11648/j.ijn.20190302.14

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    AMA Style

    Ahmed Zahe, Mahmoud Saad, Abdelghany Elshamy. Outcome of Choroid Plexus Cauterization with Endoscopic 3rd Ventriculostomy vs Ventricular Shunting in Management of Hydrocephalus Secondary to Neural Tube Defect. Int J Neurosurg. 2019;3(2):32-37. doi: 10.11648/j.ijn.20190302.14

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  • @article{10.11648/j.ijn.20190302.14,
      author = {Ahmed Zahe and Mahmoud Saad and Abdelghany Elshamy},
      title = {Outcome of Choroid Plexus Cauterization with Endoscopic 3rd Ventriculostomy vs Ventricular Shunting in Management of Hydrocephalus Secondary to Neural Tube Defect},
      journal = {International Journal of Neurosurgery},
      volume = {3},
      number = {2},
      pages = {32-37},
      doi = {10.11648/j.ijn.20190302.14},
      url = {https://doi.org/10.11648/j.ijn.20190302.14},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.ijn.20190302.14},
      abstract = {Background: Different surgical management of infants suffering neural tube defects (NTD) associated hydrocephalus were reported in the literature. Great debate whether combining endoscopic third ventriculostomy (ETV) with choroid plexus cauterization (CPC) is more effective than ventriculoperitoneal (VP) shuntfor management of congenital hydrocephalus secondary to neural tube defects ininfants younger than 1 year of age. Purpose: To evaluate and compare the therapeutic efficacy of ETV combined with CPC versus VP shunts in infants with infantile hydrocephalus associated with NTD. Methods: Thirty infants with infantile NTD associated hydrocephalus (de novo), were equally divided and randomly allocated to each intervention group either ETV/CPC or VP shunts). They were monitored for at least 6 months for any sign of raised intracranial pressure (rICP) and/or hydrocephalic metrics (fontanelle quality, HC, and ventricular size) were also documented and compared between two groups. Statistical Analysis: The association between intervention group and outcome was tested with Chi-square test and P=0.05 or less was considered statistically significant. Results: Of the total thirty patients included in the study, thirteen patients (43.3%) were male and seventeen were female (56.7%) with mean age of 80.3±11.5 days. Twenty patients (66%) were under 6 months of age. The overall success rate in 1-year follow-up was 54% and 60% for VP shunt and ETV/CPC, respectively; with the difference being not statistically significant. Conclusion: Combined ETV-CPC is considered a successful surgical option for treatment of infantile hydrocephalus associated with NTD; achieving success rate better than VPS implantation.},
     year = {2019}
    }
    

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  • TY  - JOUR
    T1  - Outcome of Choroid Plexus Cauterization with Endoscopic 3rd Ventriculostomy vs Ventricular Shunting in Management of Hydrocephalus Secondary to Neural Tube Defect
    AU  - Ahmed Zahe
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    AU  - Abdelghany Elshamy
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    JF  - International Journal of Neurosurgery
    JO  - International Journal of Neurosurgery
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    UR  - https://doi.org/10.11648/j.ijn.20190302.14
    AB  - Background: Different surgical management of infants suffering neural tube defects (NTD) associated hydrocephalus were reported in the literature. Great debate whether combining endoscopic third ventriculostomy (ETV) with choroid plexus cauterization (CPC) is more effective than ventriculoperitoneal (VP) shuntfor management of congenital hydrocephalus secondary to neural tube defects ininfants younger than 1 year of age. Purpose: To evaluate and compare the therapeutic efficacy of ETV combined with CPC versus VP shunts in infants with infantile hydrocephalus associated with NTD. Methods: Thirty infants with infantile NTD associated hydrocephalus (de novo), were equally divided and randomly allocated to each intervention group either ETV/CPC or VP shunts). They were monitored for at least 6 months for any sign of raised intracranial pressure (rICP) and/or hydrocephalic metrics (fontanelle quality, HC, and ventricular size) were also documented and compared between two groups. Statistical Analysis: The association between intervention group and outcome was tested with Chi-square test and P=0.05 or less was considered statistically significant. Results: Of the total thirty patients included in the study, thirteen patients (43.3%) were male and seventeen were female (56.7%) with mean age of 80.3±11.5 days. Twenty patients (66%) were under 6 months of age. The overall success rate in 1-year follow-up was 54% and 60% for VP shunt and ETV/CPC, respectively; with the difference being not statistically significant. Conclusion: Combined ETV-CPC is considered a successful surgical option for treatment of infantile hydrocephalus associated with NTD; achieving success rate better than VPS implantation.
    VL  - 3
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Author Information
  • Department of Neurosurgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt

  • Department of Neurosurgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt

  • Department of Neurosurgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt

  • Section