Review of Endoscopic Third Ventriculostomy Versus Ventriculoperitoneal Shunt Use in Pediatric Hydrocephalus

Authors

Penn Mattox, University of LynchburgFollow

Specialty

Pediatric Neurosurgery

Advisor

Mark Archambault

Abstract

Abstract

Objective: The use of primary and secondary endoscopic third ventriculostomy, with and without choroid plexus cauterization, has been the subjective of many studies. A systematic review of the literature was done to compare the use of endoscopic third ventriculostomy with the use of ventriculoperitoneal shunts to surgically treat pediatric hydrocephalus.

Methods: A Medline literature search was conducted with search terms pediatric, hydrocephalus, and third ventriculostomy. Nine pertinent articles were retrieved. Additional references were obtained from full-text articles reviewed. A total of 13 articles were chosen and they serve as the basis for this clinical review.

Results: Primary and secondary endoscopic third ventriculostomy, with and without choroid plexus cauterization, consistently have failure rates that are comparable to ventriculoperitoneal shunts failure rates. Careful patient selection may be the determinant for the procedure of choice.

Conclusion: Primary and secondary endoscopic third ventriculostomies, with or without choroid plexus cauterization, may be the preferred procedures to treat pediatric hydrocephalus in most children. The use of a ventriculoperitoneal shunt may be recommended if an endoscopic third ventriculostomy is not possible. Secondary third ventriculostomy, with or without choroid plexus cauterization, should be considered to treat patients with shunt malfunction or infection. Consistent follow-up among future studies must be carefully documented.

Keywords: Pediatric, hydrocephalus, third ventriculostomy

Abbreviations:

CSF: cerebrospinal fluid

VP shunt: Ventriculoperitoneal shunt

ETV: Endoscopic third ventriculostomy

CPC: Choroid plexus cauterization

HCRN: Hydrocephalus Clinical Research Network

ETVSS: Endoscopic Third Ventriculostomy Success Score

MM: Myelomeningocele

NPIH: Non-postinfectious hydrocephalus

PIH: Postinfectious hydrocephalus

ICP: Intracranial pressure

IVH: Intraventricular hemorrhage

IVC: Intraventricular catheter

Recommended Citation

Mattox P. Review of Endoscopic Third Ventriculostomy Versus Ventriculoperitoneal Shunt Use in Pediatric Hydrocephalus. University of Lynchburg DMSc Doctoral Project Assignment Repository. 2020; 2(3).